title: Value of mechanical dyssynchrony as assessed by radionuclide ventriculography to predict the cardiac resynchronization therapy response.
abstract: OBJECTIVE
  To assess the value of mechanical dyssynchrony measured by equilibrium radionuclide angiography (ERNA) in predicting long-term outcome in cardiac resynchronization therapy (CRT) patients.
  
  
  RESULTS
  We reviewed 146 ERNA studies performed in heart failure patients between 2001 and 2011 at our institution. Long-term follow-up focused on death from any cause or heart transplantation. Phase images were computed using the first harmonic Fourier transform. Intra-ventricular dyssynchrony was calculated as the delay between the earliest and most delayed 20% of the left ventricular (LV) (IntraV-20/80) and inter-ventricular dyssynchrony as the difference between LV- and right ventricular (RV)-mode phase angles (InterV). Eighty-three patients (57%) were implanted with a CRT device after ERNA. Median follow-up was 35 [21-50] months. Twenty-four events were observed during the first 41 months. Median baseline ERNA dyssynchrony values were 28 [3 to 46] degrees for intraV-20/80 and 9 [-6 to 24] degrees for interV. Comparing survival between CRT and non-CRT patients according to dyssynchrony status, log-rank tests showed no difference in survival in patients with no ERNA dyssynchrony (P = 0.34) while a significant difference was observed in ERNA patients with high level of mechanical dyssynchrony (P = 0.004).
  
  
  CONCLUSIONS
  ERNA mechanical dyssynchrony could be of value in CRT patient selection.
authors.affiliation: Cardiologie, Centre Hospitalier de l'Université de Montréal, Montreal, Canada francois.tournoux@umontreal.ca.
authors.forename: Francois
authors.initials: F
authors.lastname: Tournoux
authors.affiliation: AP-HP, Groupe Hospitalier Bichat-Claude Bernard, Service de Médecine Nucléaire, Paris, France.
authors.forename: Renata
authors.initials: R
authors.lastname: Chequer
authors.affiliation: Groupe Hospitalier Cochin-Saint Vincent de Paul, Université René Descartes-Paris 5, Paris, France.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Sroussi
authors.affiliation: AP-HP, Groupe Hospitalier Bichat-Claude Bernard, Service de Médecine Nucléaire, Paris, France.|Université Denis Diderot-Paris 7, U1148 Inserm, Paris, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Hyafil
authors.affiliation: Service de Cardiologie, CHU A. Béclère, APHP. U769, Labex Lermit, Clamart, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Algalarrondo
authors.affiliation: Service de Cardiologie, Hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, Paris 75010, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Cohen-Solal
authors.affiliation: Centre de Recherche du CHUM (CRCHUM), Université de Montréal, Québec, Canada.
authors.forename: Paule
authors.initials: P
authors.lastname: Bodson-Clermont
authors.affiliation: AP-HP, Groupe Hospitalier Bichat-Claude Bernard, Service de Médecine Nucléaire, Paris, France.|Université Denis Diderot-Paris 7, U1148 Inserm, Paris, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Le Guludec
authors.affiliation: AP-HP, Groupe Hospitalier Bichat-Claude Bernard, Service de Médecine Nucléaire, Paris, France.|Université Denis Diderot-Paris 7, U1148 Inserm, Paris, France.
authors.forename: Francois
authors.initials: F
authors.lastname: Rouzet
mesh_terms: D000367:Age Factors; D000368:Aged; D058406:Cardiac Resynchronization Therapy / Q000379:methods*; D015331:Cohort Studies; D017147:Defibrillators, Implantable; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D015635:Radionuclide Ventriculography / Q000379:methods*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome
keywords: CRT; equilibrium radionuclide angiography; heart failure; mechanical dyssynchrony