Role of Quantitative Gated SPECT in Predicting Response to Cardiac Resynchronization Therapy

Abstract

ardiac resynchronization therapy (CRT) has emerged as an exciting treatment option for the subset of heart failure (HF) patients who remain symptomatic despite optimal medical management. However, using these conventional criteria for selection of patients for CRT, it was noted that 20–45% of patients did not respond to CRT. Echocardiographic techniques such as tissue Doppler imaging (TDI) and strain rate imaging have been used to identify mechanical dyssynchrony, but these methods lack reproducibility and have not consistently been able to discriminate between responders and non-responders to CRT. Among myocardial imaging techniques, nuclear imaging has the unique advantages that it can assess myocardial perfusion, viability, and mechanical dyssynchrony and LV global function in a single scan. The aim of the work was to explore the clinical value of quantitative gated SPECT in predicting response to cardiac resynchronization therapy (CRT). This is a cross sectional prospective study that was carried out in the nuclear cardiology lab of Ain shams university hospital in the period from January 2016 to June 2018. It included 30 patients with advanced congestive heart failure eligible for CRT implantation. All patients were subjected to history taking and clinical examination, 12 lead