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Annals of Nuclear Medicine
Published in: Annals of Nuclear Medicine 9/2015

01-11-2015 | Original Article

Relationship of quantitative parameters of myocardial perfusion SPECT and ventricular arrhythmia in patients receiving cardiac resynchronization therapy

Authors: Po-Nien Hou, Shih-Chuan Tsai, Wan-Yu Lin, Chien-Ming Cheng, Kuo-Feng Chiang, Yu-Cheng Chang, Jin-Long Huang, Guang-Uei Hung, Shih-Ann Chen, Ji Chen

Published in: Annals of Nuclear Medicine | Issue 9/2015

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Abstract

Background

Ventricular arrhythmia is the major cause of sudden cardiac death for patients with heart failure, including those receiving implantation of cardiac resynchronization therapy (CRT). The purpose of this study was to assess the value of myocardial perfusion SPECT (MPS) in predicting ventricular arrhythmia for patients with CRT.

Methods and methods

Fifty-one patients (35 males, mean age 64 ± 12 years) who had received CRT for at least 6 months were enrolled for resting gated MPS. Three main quantitative parameters of MPS, including extent of myocardial scar, left ventricular ejection fraction (LVEF) and LV dyssynchrony (phase SD), were generated by Emory Cardiac Toolbox. Using the recorded ventricular arrhythmia in the device, including ventricular tachycardia (VT) and ventricular fibrillation (VF), as the primary end point, the value of quantitative parameters of MPS in predicting the development of VT/VF was assessed.

Results

Twenty (39 %) of the 51 patients developed VT/VF during the follow-up (15.3 ± 12.7 months). The patients with VT/VF had significantly lower LVEF (24 ± 12 vs. 36 ± 17 %, p < 0.005), larger scar areas (36 ± 19 vs. 22 ± 12 %, p < 0.05) and larger phase SD (57° ± 20° vs. 43° ± 17°, p < 0.01). When categorizing the patients by the median values of LVEF, scar and phase SD, univariate regression analysis showed that lower LVEF (<29 %), larger scar (>23 %) and larger phase SD (>50°) were related to the development of VT/VF (p = 0.006, 0.011 and 0.064, respectively). However, only LVEF was marginally significant as an independent predictor of VT//VF on multivariate regression analysis (p = 0.0573). Survival analysis with Kaplan–Meier curves showed that the survival probability for VT/VF in those with LVEF >29 %, scar areas <23 % and phase SD < 50° was significantly better than in the others (HR 5.16, 95 % CI 1.20–22.16) by log-rank test (χ 2 = 5.9894, p = 0.014).

Conclusion

Lower LVEF, larger scar and/or more dyssynchrony assessed by MPS were related to the development of ventricular arrhythmia for patients with CRT, and further defibrillator implantation may be considered for these patients.
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Metadata
Title
Relationship of quantitative parameters of myocardial perfusion SPECT and ventricular arrhythmia in patients receiving cardiac resynchronization therapy
Authors
Po-Nien Hou
Shih-Chuan Tsai
Wan-Yu Lin
Chien-Ming Cheng
Kuo-Feng Chiang
Yu-Cheng Chang
Jin-Long Huang
Guang-Uei Hung
Shih-Ann Chen
Ji Chen
Publication date
01-11-2015
Publisher
Springer Japan
Published in
Annals of Nuclear Medicine / Issue 9/2015
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-015-1007-1

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