title: Research of predictive factors for cardiac resynchronization therapy: a prospective study comparing data from phase-analysis of gated myocardial perfusion single-photon computed tomography and echocardiography : Trying to anticipate response to CRT.
abstract: BACKGROUND
  Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in chronic systolic heart failure. About 20% of implanted patients are considered as "non-responders". This study aimed to evaluate gated myocardial perfusion single-photon emission computed tomography (GMPS) phase parameters as compared to echocardiography in the assessment of predictors for response to CRT before and after CRT activation.
  
  
  METHODS
  Forty-two patients were prospectively included during 15 months. A single injection of99mTc-tetrofosmin was used to acquire GMPS phase pre- and post-CRT activation. Indicators of positive CRT response were improvement of functional status and 15% reduction in left ventricular end-systolic volume at 3 months.
  
  
  RESULTS
  Phase parameters at baseline were similar in the two groups with no influence of perfusion data. Phase parameters after CRT activation were significantly improved in the responders' group (Δ Bandwidth -19° ± 24° vs. 13° ± 31°, p = 0.001; Δ SD -20° ± 30° vs. 26° ± 46°, p = 0.001; Δ Entropy -11 ± 12 vs. 2 ± 6%, p = 0.001). Feasibility and reproducibility were higher for GMPS.
  
  
  CONCLUSIONS
  Acute phase modifications after CRT activation may predict response to CRT immediately after implantation, but not at baseline, even when adjusted to perfusion data.
authors.affiliation: Department of Cardiology, Toulouse University Hospital, Toulouse, France. remygendre@hotmail.com.|Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France. remygendre@hotmail.com.|Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France. remygendre@hotmail.com.
authors.forename: Rémy
authors.initials: R
authors.lastname: Gendre
authors.affiliation: Department of Cardiology, Toulouse University Hospital, Toulouse, France.|Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France.|Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France.|Medical School of Rangueil, University Paul Sabatier, Toulouse, France.|Medical School of Purpan, University Paul Sabatier, Toulouse, France.
authors.forename: O
authors.initials: O
authors.lastname: Lairez
authors.affiliation: Department of Cardiology, Toulouse University Hospital, Toulouse, France.
authors.forename: P
authors.initials: P
authors.lastname: Mondoly
authors.affiliation: Department of Cardiology, Toulouse University Hospital, Toulouse, France.
authors.forename: A
authors.initials: A
authors.lastname: Duparc
authors.affiliation: Department of Cardiology, Toulouse University Hospital, Toulouse, France.|Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France.|Medical School of Purpan, University Paul Sabatier, Toulouse, France.
authors.forename: D
authors.initials: D
authors.lastname: Carrié
authors.affiliation: Department of Cardiology, Toulouse University Hospital, Toulouse, France.|Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France.|Medical School of Rangueil, University Paul Sabatier, Toulouse, France.
authors.forename: M
authors.initials: M
authors.lastname: Galinier
authors.affiliation: Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France.|Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France.|Medical School of Rangueil, University Paul Sabatier, Toulouse, France.|Medical School of Purpan, University Paul Sabatier, Toulouse, France.
authors.forename: I
authors.initials: I
authors.lastname: Berry
authors.affiliation: Department of Cardiology, Toulouse University Hospital, Toulouse, France.|Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France.|Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France.
authors.forename: T
authors.initials: T
authors.lastname: Cognet
mesh_terms: D000368:Aged; D058406:Cardiac Resynchronization Therapy / Q000379:methods*; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D015588:Observer Variation; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012984:Software; D013599:Systole / Q000187:drug effects; D013667:Technetium / Q000737:chemistry; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome
chemical_list: D013667:Technetium
keywords: Cardiac resynchronization therapy; Gated single-photon emission computed tomography; Heart failure; Left ventricular dyssynchrony