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Pulmonary perfusion and NYHA classification improve after cardiac resynchronization therapy

Al-Mashat, Mariam LU ; Borgquist, Rasmus LU orcid ; Carlsson, Marcus LU ; Arheden, Håkan LU and Jögi, Jonas LU orcid (2022) In Journal of Nuclear Cardiology 29(6). p.2974-2983
Abstract

Background: Evaluation of cardiac resynchronization therapy (CRT) often includes New York Heart Association (NYHA) classification, and echocardiography. However, these measures have limitations. Perfusion gradients from ventilation/perfusion single-photon emission computed tomography (V/P SPECT) are related to left-heart filling pressures and have been validated against invasive right-heart catheterization. The aim was to assess if changes in perfusion gradients are associated with improvements in heart failure (HF) symptoms after CRT, and if they correlate with currently used diagnostic methods in the follow-up of patients with HF after receiving CRT. Methods and results: Nineteen patients underwent V/P SPECT, echocardiography, NYHA... (More)

Background: Evaluation of cardiac resynchronization therapy (CRT) often includes New York Heart Association (NYHA) classification, and echocardiography. However, these measures have limitations. Perfusion gradients from ventilation/perfusion single-photon emission computed tomography (V/P SPECT) are related to left-heart filling pressures and have been validated against invasive right-heart catheterization. The aim was to assess if changes in perfusion gradients are associated with improvements in heart failure (HF) symptoms after CRT, and if they correlate with currently used diagnostic methods in the follow-up of patients with HF after receiving CRT. Methods and results: Nineteen patients underwent V/P SPECT, echocardiography, NYHA classification, and the quality-of-life scoring system “Minnesota living with HF” (MLWHF), before and after CRT. CRT caused improvement in perfusion gradients from V/P SPECT which were associated with improvements in NYHA classification (P =.0456), whereas improvements in end-systolic volume (LVESV) from echocardiography were not. After receiving CRT, the proportion of patients who improved was lower using LVESV (n = 7/19, 37%) than perfusion gradients (n = 13/19, 68%). Neither change in perfusion gradients nor LVESV was associated with changes in MLWHF (P = 1.0, respectively). Conclusions: Measurement of perfusion gradients from V/P SPECT is a promising quantitative user-independent surrogate measure of left-sided filling pressure in the assessment of CRT response in patients with HF.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiac resynchronization therapy, echocardiography, heart failure, NYHA classification, ventilation/perfusion single-photon emission computed tomography
in
Journal of Nuclear Cardiology
volume
29
issue
6
pages
2974 - 2983
publisher
Springer
external identifiers
  • scopus:85118574781
  • pmid:34750725
ISSN
1071-3581
DOI
10.1007/s12350-021-02848-8
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2021, The Author(s).
id
b8ceb941-c3eb-4850-8fbb-2eb880256f51
date added to LUP
2021-12-02 11:22:34
date last changed
2024-06-15 21:48:23
@article{b8ceb941-c3eb-4850-8fbb-2eb880256f51,
  abstract     = {{<p>Background: Evaluation of cardiac resynchronization therapy (CRT) often includes New York Heart Association (NYHA) classification, and echocardiography. However, these measures have limitations. Perfusion gradients from ventilation/perfusion single-photon emission computed tomography (V/P SPECT) are related to left-heart filling pressures and have been validated against invasive right-heart catheterization. The aim was to assess if changes in perfusion gradients are associated with improvements in heart failure (HF) symptoms after CRT, and if they correlate with currently used diagnostic methods in the follow-up of patients with HF after receiving CRT. Methods and results: Nineteen patients underwent V/P SPECT, echocardiography, NYHA classification, and the quality-of-life scoring system “Minnesota living with HF” (MLWHF), before and after CRT. CRT caused improvement in perfusion gradients from V/P SPECT which were associated with improvements in NYHA classification (P =.0456), whereas improvements in end-systolic volume (LVESV) from echocardiography were not. After receiving CRT, the proportion of patients who improved was lower using LVESV (n = 7/19, 37%) than perfusion gradients (n = 13/19, 68%). Neither change in perfusion gradients nor LVESV was associated with changes in MLWHF (P = 1.0, respectively). Conclusions: Measurement of perfusion gradients from V/P SPECT is a promising quantitative user-independent surrogate measure of left-sided filling pressure in the assessment of CRT response in patients with HF.</p>}},
  author       = {{Al-Mashat, Mariam and Borgquist, Rasmus and Carlsson, Marcus and Arheden, Håkan and Jögi, Jonas}},
  issn         = {{1071-3581}},
  keywords     = {{Cardiac resynchronization therapy; echocardiography; heart failure; NYHA classification; ventilation/perfusion single-photon emission computed tomography}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{2974--2983}},
  publisher    = {{Springer}},
  series       = {{Journal of Nuclear Cardiology}},
  title        = {{Pulmonary perfusion and NYHA classification improve after cardiac resynchronization therapy}},
  url          = {{http://dx.doi.org/10.1007/s12350-021-02848-8}},
  doi          = {{10.1007/s12350-021-02848-8}},
  volume       = {{29}},
  year         = {{2022}},
}