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Open Access 01-12-2019 | Echocardiography | Original research

Low septal to lateral wall ¹⁸F-FDG ratio is highly associated with mechanical dyssynchrony in non-ischemic CRT candidates

Authors: Ganna Degtiarova, Piet Claus, Jürgen Duchenne, Marta Cvijic, Georg Schramm, Johan Nuyts, Jens-Uwe Voigt, Olivier Gheysens

Published in: EJNMMI Research | Issue 1/2019

Abstract

Background

In order to better understand the concept of mechanical dyssynchrony, a promising hallmark of cardiac resynchronization therapy (CRT) response, we investigated its effect on regional myocardial metabolism and myocardial blood flow (MBF) in non-ischemic CRT candidates.

Results

Thirty consecutive non-ischemic CRT eligible patients underwent static ¹⁸F-FDG and resting dynamic ¹³N-NH₃ PET/CT. ¹⁸F-FDG uptake and MBF for septal and lateral wall were analysed and septal-to-lateral wall ratios (SLR) were calculated. Based on the presence of mechanical dyssynchrony (septal flash and/or apical rocking) on echocardiography, patients were divided into 2 groups, with (n = 23) and without (n = 7) mechanical dyssynchrony.

Patients with mechanical dyssynchrony had significantly lower ¹⁸F-FDG SUVmean in the septum compared with the lateral wall (5.58 ± 2.65 vs 11.19 ± 4.10, p < 0.0001), while patients without mechanical dyssynchrony had a more homogeneous ¹⁸F-FDG distribution (7.33 ± 2.88 vs 8.31 ± 2.50, respectively, p = 0.30). Similarly, MBF was significantly different between the septal and lateral wall in the dyssynchrony group (0.57 ± 0.11 ml/g/min vs 0.92 ± 0.23 ml/g/min, respectively, p < 0.0001), whereas no difference was observed in the non-dyssynchrony group (0.61 ± 0.23 ml/g/min vs 0.77 ± 0.21 ml/g/min, respectively, p = 0.16). ¹⁸F-FDG SLR, but not MBF SLR, was associated with the presence of mechanical dyssynchrony and showed a significant inverse correlation with volumetric reverse remodeling after CRT (r = − 0.62, p = 0.001).

Conclusions

Non-ischemic heart failure patients with mechanical dyssynchrony demonstrate heterogeneous regional metabolism and MBF compared with patients without dyssynchrony. However, only ¹⁸F-FDG SLR appeared to be highly associated with the presence of mechanical dyssynchrony.

Trial registration

Clinicaltrials, NCT02537782. Registered 2 September 2015.

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Title: Low septal to lateral wall 18F-FDG ratio is highly associated with mechanical dyssynchrony in non-ischemic CRT candidates
Authors: Ganna Degtiarova
Piet Claus
Jürgen Duchenne
Marta Cvijic
Georg Schramm
Johan Nuyts
Jens-Uwe Voigt
Olivier Gheysens
Publication date: 01-12-2019
Publisher: Springer Berlin Heidelberg
Keywords: Echocardiography
Left Bundle Branch Block
Echocardiography
Positron Emission Tomography
Cardiac Resynchronization Therapy
Cardiac Resynchronization Therapy
Cardiac Resynchronization Therapy
Cardiac Resynchronization Therapy
Published in: EJNMMI Research / Issue 1/2019
Electronic ISSN: 2191-219X
DOI: https://doi.org/10.1186/s13550-019-0575-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Low septal to lateral wall ¹⁸F-FDG ratio is highly associated with mechanical dyssynchrony in non-ischemic CRT candidates

Abstract

Background

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Results

Conclusions

Trial registration

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