期刊
AMERICAN HEART JOURNAL
卷 153, 期 1, 页码 105-112出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.ahj.2006.10.015
关键词
-
Background About 30% of patients with heart failure do not respond to cardiac resynchronization therapy (CRT). We hypothesized that scar burden can predict poor response to CRT in patients with ischemic cardiomyopathy (ICM). Methods Fifty patients (age, 68.5 +/- 9.2 years; 84% men; mean left ventricular ejection fraction (LVEF), 19.7% +/- 5.2%) with ICM who underwent CRT-defibrillator implantation and (TI)-T-201 single photon emission computed tomography myocardial perfusion imaging were included. Myocardial perfusion imaging studies were read quantitatively, generating a summed perfusion score (SPS). Left ventricular (LV) lead position was determined by chest radiography. Echocardiograms were performed before and after (median, 11.0 months) CRT. Results Echocardiographic response, defined as >= 15% relative increase in LVEF, was documented in 28 (56%) patients. The mean SPS (18.8 +/- 11.3 vs 33.7 +/- 11.1; P = .000025) and the average scar density in the segments immediately adjacent to the LV lead (0.70 +/- 0.91 vs 1.64 +/- 0.82; P =.0004) were significantly lower in responders versus nonresponders. Global scar burden (r = -0.53; P = .00007), scar burden near the LV lead (r = -0.49; P = .0003), and the number of segments with a score of 4 (r = -0.53; P = .0007) inversely correlated with increase in LVEF after CRT. The hazard ratio for nonresponse increased with increasing tertiles of global SPS, scar density in the vicinity of the LV lead, and number of segments with transmural scar (ie, perfusion score = 4). Conclusions Higher overall scar burden, a larger number of severely scarred segments, and greater scar density near the LV lead tip portend an unfavorable response to CRT in ICM patients. Prospective confirmation of these findings is warranted.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据