Top

Published in:

Open Access 01-08-2021 | Computed Tomography | Original Article

A novel approach to the selection of an appropriate pacing position for optimal cardiac resynchronization therapy using CT coronary venography and myocardial perfusion imaging: FIVE STaR method (fusion image using CT coronary venography and perfusion SPECT applied for cardiac resynchronization therapy)

Authors: Tomohiro Tada, MD, PhD, Koichi Osuda, RT, Tomoaki Nakata, MD, PhD, Ippei Muranaka, MD, Masafumi Himeno, MD, Shingo Muratsubaki, MD, PhD, Hiromichi Murase, MD, PhD, Kenji Sato, MD, Masanori Hirose, MD, PhD, Takayuki Fukuma, MD, PhD

Published in: Journal of Nuclear Cardiology | Issue 4/2021

Abstract

Background

Nearly one-third of patients with advanced heart failure (HF) do not benefit from cardiac resynchronization therapy (CRT). We developed a novel approach for optimizing CRT via a simultaneous assessment of the myocardial viability and an appropriate lead position using a fusion technique with CT coronary venography and myocardial perfusion imaging.

Methods and Results

The myocardial viability and coronary venous anatomy were evaluated by resting Tc-99m-tetrofosmin myocardial perfusion imaging (MPI) and contrast CT venography, respectively. Using fusion images reconstructed by MPI and CT coronary venography, the pacing site and lead length were determined for appropriate CRT device implantations in 4 HF patients. The efficacy of this method was estimated by the symptomatic and echocardiographic functional parameters. In all patients, fusion images using MPI and CT coronary venograms were successfully reconstructed without any misregistration and contributed to an effective CRT. Before the surgery, this method enabled the operators to precisely identify the optimal indwelling site, which exhibited myocardial viability and had a lead length necessary for an appropriate device implantation.

Conclusions

The fusion image technique using myocardial perfusion imaging and CT coronary venography is clinically feasible and promising for CRT optimization and enhancing the patient safety in patients with advanced HF.

Available only for authorised users

Vasan RS, Larson MG, Benjamin EJ, Evans JC, Reiss CK, Levy D. Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction: Prevalence and mortality in a population-based cohort. J Am Coll Cardiol 1999;33:1948-55. https://doi.org/10.1016/S0735-1097(99)00118-7.CrossRefPubMed

Shiba N, Watanabe J, Shinozaki T, Koseki Y, Sakuma M, Kagaya Y, et al. Analysis of chronic heart failure registry in the Tohoku district: Third year follow-up. Circ J 2004;68:427-34.CrossRef

Shiba N, Nochioka K, Miura M, Kohno H, Shimokawa H, CHART-2 Investigators. Trend of westernization of etiology and clinical characteristics of heart failure patients in Japan. Circ J 2011;75:823-33. https://doi.org/10.1253/circj.cj-11-0135.CrossRefPubMed

Ushigome R, Sakata Y, Nochioka K, Miyata S, Miura M, Tadaki S, et al. Temporal trends in clinical characteristics, management and prognosis of patients with symptomatic heart failure in Japan: Report From the CHART Studies. Circ J 2015;79:2396-407. https://doi.org/10.1253/circj.CJ-15-0514.CrossRefPubMed

Sipahi I, Carrigan TP, Rowland DY, Stambler BS, Fang JC. Impact of QRS duration on clinical event reduction with cardiac resynchronization therapy: Meta-analysis of randomized controlled trials. Arch Intern Med 2011;171:1454-62. https://doi.org/10.1001/archinternmed.2011.247.CrossRefPubMed

Yancy CW, Jessup M, Bozkurt B, Buler J, Casey DE, Dazner MH, et al. 2013 ACCF/AHA guideline for the management of heart failure. J Am Coll Cardiol 2013;62:e147-239. https://doi.org/10.1016/j.jacc.2013.05.019.CrossRefPubMed

Abraham WT, Fisher WG, Smith AL, Delurgio DB, Leon AR, Loh E, et al. Cardiac resynchronization in chronic heart failure. N Engl J Med 2002;346:1845-53. https://doi.org/10.1056/NEJMoa013168.CrossRefPubMed

Fox DJ, Fitzpatrick AP, Davidson NC. Optimisation of cardiac resynchronisation therapy: Addressing the problem of “non-responders”. Heart 2005;91:1000-2.CrossRef

Chung ES, Leon AR, Tavazzi L, sun JP, Nihoyannopoulos P, Merlino J, et al. Results of the predictors of response to crt (prospect) trial. Circulation 2008;117:2608-16. https://doi.org/10.1161/CIRCULATIONAHA.107.743120.CrossRefPubMed

10.

Hawkins NM, Petrie MC, Burgess MI, McMurray JJV. Selecting patients for cardiac resynchronization therapy. The fallacy of echocardiographic dyssynchrony. J Am Coll Cardiol 2009;53:1944-59.CrossRef

11.

Tracy CM, Epstein AE, Darbar D, DiMarco JP, Estes SB, Dunbar NM, et al. 2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities. J Am Coll Cardiol 2013;61:e6-75. https://doi.org/10.1016/j.jacc.2012.11.007.CrossRefPubMed

12.

Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, Falk V, González-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GMC, Ruilope LM, Ruschitzka F, van der Rutten FH. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2016;37:2129-200. https://doi.org/10.1016/j.rec.2016.10.015.CrossRef

13.

Tsutsui H (2018) Guidelines for diagnosis and treatment of acute and chronic heart Failure (JCS 2017/JHFS 2017). http://www.j-circ.or.jp/guideline/pdf/JCS2017_tsutsui_h.pdf.

14.

Delgado V, van Bommel RJ, Bertini M, Borleffs CJ, Marsan NA, Ng NC, et al. Relative merits of left ventricular dyssynchrony, left ventricular lead position, and myocardial scar to predict long-term survival of ischemic heart failure patients undergoing cardiac resynchronization therapy. Circulation 2011;123:70-8. https://doi.org/10.1161/CIRCULATIONAHA.110.945345.CrossRefPubMed

15.

Romeyer-Bouchard C, Da Costa A, Dauphinot V, Messier M, Bisch L, Samuel B, et al. Prevalence and risk factors related to infections of cardiac resynchronization therapy devices. Eur Heart J 2010;31:203-10. https://doi.org/10.1093/eurheartj/ehp421.CrossRefPubMed

16.

Polyzos KA, Konstantelias AA, Falagas ME. Risk factors for cardiac implantable electronic device infection: A systematic review and meta-analysis. Europace 2015;17:767-77.CrossRef

17.

Bleeker GB, Kaandorp TAM, Lamb HJ, Steendijk P, de Roos A, van der Wall EE, et al. Effect of posterolateral scar tissue on clinical and echocardiographic improvement after cardiac resynchronization therapy. Circulation 2006;113:969-76. https://doi.org/10.1161/CIRCULATIONAHA.105.543678.CrossRefPubMed

18.

Udelson JE, Coleman PS, Metherall J, Pandian NG, Gomez AR, Griffith JL, et al. Predicting recovery of severe regional ventricular dysfunction: Comparison of resting scintigraphy with 201Tl and 99mTc-sestamibi. Circulation 1994;5:6. https://doi.org/10.1161/01.CIR.89.6.2552.CrossRef

19.

Nishisato K, Hashimoto A, Nakata T, Doi T, Yamamoto H, Nagahara D, et al. Impaired cardiac sympathetic innervation and myocardial perfusion are related to lethal arrhythmia: Quantification of cardiac tracers in patients with ICDs. J Nucl Med 2010. https://doi.org/10.2967/jnumed.110.074971.CrossRefPubMed

20.

Doi T, Nakata T, Yuda S, Hashimoto A. Synergistic prognostic implications of left ventricular mechanical dyssynchrony and impaired cardiac sympathetic nerve activity in heart failure patients with reduced left ventricular ejection fraction. Eur Heart J Cardiovasc Imaging 2018;19:74-83. https://doi.org/10.1093/ehjci/jew334.CrossRefPubMed

21.

Schindler TH, Magosaki N, Jeserich M, Oser U, Krause T, Fischer R, et al. Fusion imaging: Combined visualization of 3D reconstructed coronary artery tree and 3D myocardial scintigraphic image in coronary artery disease. Int J Cardiac Imaging 1999;15:357-68. https://doi.org/10.1023/A:1006232407637.CrossRef

22.

Schindler TH, Magosaki N, Jeserich M, Nitzsche E, Oser U, Abdollahnia T, et al. 3D Assessment of myocardial perfusion parameter combined with 3D reconstructed coronary artery tree from digital coronary angiograms. Int J Cardiac Imaging 2000;16:1-12. https://doi.org/10.1023/A:1006216221695.CrossRef

23.

Faber TL, Santana CA, Garcia EV, Candell-Riera J, Folks RD, Peifer JW, et al. Three-dimensional fusion of coronary arteries with myocardial perfusion distributions: Clinical validation. J Nucl Med 2004;45:745-53.PubMed

24.

Zhou W, Hou X, Piccinelli M, Tang X, Tang L, Cao K, et al. 3D Fusion of LV Venous anatomy on fluoroscopy venograms with epicardial surface on SPECT myocardial perfusion images for guiding CRT LV lead placement. JACC Cardiovasc Imaging 2014;7:1239-48. https://doi.org/10.1016/j.jcmg.2014.09.002.CrossRefPubMed

25.

Sieniewicz BJ, Gould J, Porter B, Sidhu BS, Behar JM, Claridge S, et al. Optimal site selection and image fusion guidance technology to facilitate cardiac resynchronization therapy. Expert Rev Med Dev 2018;15:555-70. https://doi.org/10.1080/17434440.2018.1502084.CrossRef

26.

Nakaura T, Utsunomiya D, Shiraishi S, Tomiguchi S, Honda T, Ogawa H, et al. Three-dimensional cardiac image fusion using new CT angiography and SPECT methods. Am J Roentgenol 2005;185:1554-7. https://doi.org/10.2214/AJR.04.1401.CrossRef

27.

Fornwalt BK, Sprague WW, Bedell P, Suever JD, Gerritse B, Merlino JD, et al. Agreement is poor among current criteria used to define response to cardiac resynchronization therapy. Circulation 2010;121:1985-91.CrossRef

Title: A novel approach to the selection of an appropriate pacing position for optimal cardiac resynchronization therapy using CT coronary venography and myocardial perfusion imaging: FIVE STaR method (fusion image using CT coronary venography and perfusion SPECT applied for cardiac resynchronization therapy)
Authors: Tomohiro Tada, MD, PhD
Koichi Osuda, RT
Tomoaki Nakata, MD, PhD
Ippei Muranaka, MD
Masafumi Himeno, MD
Shingo Muratsubaki, MD, PhD
Hiromichi Murase, MD, PhD
Kenji Sato, MD
Masanori Hirose, MD, PhD
Takayuki Fukuma, MD, PhD
Publication date: 01-08-2021
Publisher: Springer International Publishing
Keywords: Computed Tomography
Computed Tomography
Heart Failure
Cardiac Resynchronization Therapy
Phlebography
Cardiac Resynchronization Therapy
Cardiac Resynchronization Therapy
Cardiac Resynchronization Therapy
Published in: Journal of Nuclear Cardiology / Issue 4/2021
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI: https://doi.org/10.1007/s12350-019-01856-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods and Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods and Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 4/2021

Impact of optimized PET imaging conditions on 18F-FDG uptake quantification in patients with apparently normal aortas

Nuclear cardiology in the literature: A selection of recent, original research papers

Quantification of myocardial blood flow (MBF) and reserve (MFR) incorporated with a novel segmentation approach: Assessments of quantitative precision and the lower limit of normal MBF and MFR in patients

A big step towards clinical implementation of myocardial blood flow quantification with CZT SPECT

Factors that impact a patient’s experience when undergoing single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) in the US: A survey of patients, imaging center staff, and physicians

Left ventricular myocardial volume in CZT SPECT: Expanding the horizon?