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. 2022 Aug;29(4):1611-1625.
doi: 10.1007/s12350-021-02554-5. Epub 2021 Feb 24.

Improved risk-stratification in heart failure patients with mid-range to severe abnormalities of QRS duration and systolic function using mechanical dyssynchrony assessed by myocardial perfusion-gated SPECT

Takahiro Doi  1 , Tomoaki Nakata  2 , Takahiro Noto  3 , Tomohiro Mita  3 , Satoshi Yuda  3 , Akiyoshi Hashimoto  4
Affiliations

Improved risk-stratification in heart failure patients with mid-range to severe abnormalities of QRS duration and systolic function using mechanical dyssynchrony assessed by myocardial perfusion-gated SPECT

Takahiro Doi et al. J Nucl Cardiol. 2022 Aug.

Abstract

Background: The use of left ventricular mechanical dyssynchrony (LVMD), which has been reported to be responsible for unfavorable outcomes, might improve conventional risk-stratification by clinical indices including QRS duration (QRSd) and systolic dysfunction in patients with heart failure (HF).

Methods and results: Following measurements of 12-lead QRSd and left ventricular ejection fraction (LVEF), three-dimensional (3-D) LVMD was evaluated as a standard deviation (phase SD) of regional mechanical systolic phase angles by gated myocardial perfusion imaging in 829 HF patients. Patients were followed up for a mean period of 37 months with a primary endpoint of lethal cardiac events (CEs). In an overall multivariate Cox proportional hazards model, phase SDs were identified as significant prognostic determinants independently. The patients were divided into 4 groups by combining with the cut-off values of LVEF (35% and 50%) and QRSd (130 ms and 150 ms). The groups with lower LVEF and prolonged QRSd more frequently had CEs than did the other groups. Patient groups with LVEF < 35% and with 35% ≦ LVEF < 50% were differentiated into low-risk and high-risk categories by using an optimal phase SD cut-off value of both QRSd thresholds.

Conclusions: 3-D LVMD can risk-stratify HF patients with mid-range as well as severe abnormalities of QRSd and systolic dysfunction.

Keywords: Heart failure; Left ventricular mechanical dyssynchrony; Prognosis; QRS duration; Risk-stratification.

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References

    1. Epstein AE, DiMarco JP, Ellenbogen KA, Estes NA, Freedman RA, Gettes LS, et al. American College of Cardiology Foundation; American Heart Association Task Force on Practice Guidelines; Heart Rhythm Society. 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. - DOI
    1. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2016;37:2129-200. - DOI
    1. Tsutsui H, Isobe Mitsuaki, Ito Hiroshi, Okumura Ken, Ono Minoru, Kitakaze Masafumi, et al. Guidelines for diagnosis and treatment of acute and chronic heart failure. Circ J 2019;83:2084-184. - DOI
    1. 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. - DOI
    1. Fox DJ, Fitzpatrick AP, Davidson NC. Optimisation of cardiac resynchronisation therapy: Addressing the problem of ‘non-responders’. Heart 2005;91:1000-2. - DOI

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