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J Nucl Med. 2008; 49 (Supplement 1):204P
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Cardiovascular: Clinical Science

Clinical Science Posters

Evaluation of equilibrium radionuclide angiogram derived measures of interventricular dyssynchrony in heart failure patients requiring cardiac resynchronization therapy

Nitish Badhwar1, Deanna Green1, John O'Connell1, Teresa DeMarco1 and Elias Botvinick1

1 UCSF, San Francisco, California

882

Objectives: We used equilibrium radionuclide angiogram (ERNA) to measure interventricular dyssynchrony (IVD) in heart failure pts indicated for cardiac resynchronization therapy (CRT) and correlated it with clinical outcomes.

Methods: We studied 46 pts with advanced HF, LVEF≤35% and wide QRS who were indicated for CRT. ERNA was used to calculate the difference in mean RV and LV phase angle (mean RV-LV Ø) as a parameter of IVD. This was compared to parameters of intraventricular LV dyssynchrony that are standard deviation of phase (SD Ø), synchrony (S) (vector sum of all regional LV amplitudes divided by scalar sum of amplitudes) and entropy (E) that measures the degree of LV contraction randomness or disorder. Serial changes in these parameters were compared to clinical outcomes after CRT.

Results: Pts were followed for > 6 months and were graded 2 (n=15), 1 (n=18) or 0 (n=13) if they improved 2, 1 or 0 NYHA classes, respectively after CRT.


Figure 1
Clinical Improvement in NYHA Class

There were no significant differences in serially measured mean RV-LV Ø between grade 0 and 2. This value fell significantly between grades 1 and 2, similar to findings for LVEF. However, S and E improved significantly and differentiated between all 3 grades.

Conclusions: Unlike intraLV dyssnchrony, ERNA derived parameter of interventricular dyssynchrony was unable to differentiate between CRT responders and non-repsonders.

Research Support: Philips





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Right arrow Articles by Botvinick, E.