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Peix A, Padrón K, Cabrera LO, Castañeda O, Milán D, Castro J, Falcón R, Martínez F, Rodríguez L, Sánchez J, Mena E, Carrillo R, Fernández Y, Escarano R, Páez D, Dondi M. Intraventricular synchronism assessment by gated-SPECT myocardial perfusion imaging in cardiac resynchronization therapy. Does cardiomyopathy type influence results? EJNMMI Res 2020; 10:125. [PMID: 33079263 PMCID: PMC7575672 DOI: 10.1186/s13550-020-00703-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/17/2020] [Indexed: 12/05/2022] Open
Abstract
Purpose To analyze the evolution post-cardiac resynchronization therapy (CRT) in left ventricular non-compaction (LVNC) cardiomyopathy (CM) patients compared to other types of CM, according to clinical and functional variables, by using gated-SPECT myocardial perfusion imaging (MPI).
Methods Ninety-three patients (60 ± 11 years, 28% women) referred for pre-CRT assessment were studied and divided into three groups: 1 (non-ischemic CM with LVNC, 11 patients), 2 (ischemic CM, 28 patients), and 3 (non-ischemic CM, 53 patients). All were studied by a 99mTc-MIBI gated-SPECT MPI at rest pre-CRT implantation and 6 ± 1 months after, including intraventricular dyssynchrony assessment by phase analysis. Quality of life was measured by the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Results No differences in sex, atherosclerotic risk factors other than smoking habit, and MLHFQ results were found among groups. LVNC CM patients were younger, with greater QRS width and lower left ventricular ejection fraction (LVEF) at baseline, but the differences were not significant. No significant differences were found at baseline regarding ventricular function, although end-systolic volume was slightly higher in LVNC CM patients. Mean SRS was significantly higher (p < 0.0001) in ischemic patients (14.9) versus non-ischemic ones (8.7 in group 1 and 9 in group 2). At baseline, LVNC CM patients were significantly more dyssynchronous: Their phase standard deviation (PSD) was higher (89.5° ± 14.2°) versus groups 2 (65.2° ± 23.3°) and 3 (69.7° ± 21.7°), p = 0.007. Although the quality of life significantly improved in all groups, non-ischemic patients (with or without LVNC) showed a higher LVEF increase and volumes reduction at 6 months post-CRT. Dyssynchrony reduced post-CRT in all groups. Nevertheless, those more dyssynchronous at baseline (LVNC CM) exhibited the most significant intraventricular synchronism improvement: PSD was reduced from 89.5° ± 14.2° at baseline to 63.7° ± 20.5° post-CRT (p = 0.028). Six months post-CRT, 89% of patients were responders: 11 (100%) of those with LVNC CM, 25 (86%) of those with ischemic CM, and 47 (89%) of patients with non-ischemic CM. No patient with LVNC CM had adverse events during the follow-up. Conclusion CRT contributes to a marked improvement in non-ischemic CM patients with non-compaction myocardium. Phase analysis in gated-SPECT MPI is a valuable tool to assess the response to CRT.
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Affiliation(s)
- Amalia Peix
- Nuclear Medicine Department, Institute of Cardiology and Cardiovascular Surgery, 17 #702, Vedado, 10 400, La Habana, Cuba.
| | - Kenia Padrón
- Nuclear Medicine Department, Institute of Cardiology and Cardiovascular Surgery, 17 #702, Vedado, 10 400, La Habana, Cuba
| | - Lázaro O Cabrera
- Nuclear Medicine Department, Institute of Cardiology and Cardiovascular Surgery, 17 #702, Vedado, 10 400, La Habana, Cuba
| | - Osmín Castañeda
- Nuclear Medicine Department, Institute of Cardiology and Cardiovascular Surgery, 17 #702, Vedado, 10 400, La Habana, Cuba
| | - Danet Milán
- Nuclear Medicine Department, Institute of Cardiology and Cardiovascular Surgery, 17 #702, Vedado, 10 400, La Habana, Cuba
| | - Jesús Castro
- Nuclear Medicine Department, Institute of Cardiology and Cardiovascular Surgery, 17 #702, Vedado, 10 400, La Habana, Cuba
| | - Roylan Falcón
- Nuclear Medicine Department, Institute of Cardiology and Cardiovascular Surgery, 17 #702, Vedado, 10 400, La Habana, Cuba
| | - Frank Martínez
- Nuclear Medicine Department, Institute of Cardiology and Cardiovascular Surgery, 17 #702, Vedado, 10 400, La Habana, Cuba
| | - Lydia Rodríguez
- Nuclear Medicine Department, Institute of Cardiology and Cardiovascular Surgery, 17 #702, Vedado, 10 400, La Habana, Cuba
| | - Jesús Sánchez
- Nuclear Medicine Department, Institute of Cardiology and Cardiovascular Surgery, 17 #702, Vedado, 10 400, La Habana, Cuba
| | - Erick Mena
- Nuclear Medicine Department, Institute of Cardiology and Cardiovascular Surgery, 17 #702, Vedado, 10 400, La Habana, Cuba
| | - Regla Carrillo
- Nuclear Medicine Department, Institute of Cardiology and Cardiovascular Surgery, 17 #702, Vedado, 10 400, La Habana, Cuba
| | - Yoel Fernández
- Nuclear Medicine Department, Institute of Cardiology and Cardiovascular Surgery, 17 #702, Vedado, 10 400, La Habana, Cuba
| | - Ricardo Escarano
- Nuclear Medicine Department, Institute of Cardiology and Cardiovascular Surgery, 17 #702, Vedado, 10 400, La Habana, Cuba
| | - Diana Páez
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Maurizio Dondi
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
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Kochmareva EA, Kokorin VA, Kondrashova EA, Khokhlova NV, Vardanyan AG, Kokorin IA, Doroshenko DA. Left Ventricle Non-Compaction Myocardium and Thrombophilia in a Pregnant Woman. Eur J Case Rep Intern Med 2016; 3:000432. [PMID: 30755883 PMCID: PMC6346967 DOI: 10.12890/2016_000432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 05/02/2016] [Indexed: 11/22/2022] Open
Abstract
Non-compaction of the ventricular myocardium (NCM) is a genetic cardiomyopathy usually due to mutationof the G4.5 gene located in the Xq28 chromosomal region. This congenital disorder is characterized by pronounced trabeculations and intertrabecular recesses resulting from abnormal embryogenesis between the fifth and eighth fetal weeks. The reported prevalence in the general population is between 0.014% and 1.3%. The classic triad of complications includes heart failure, ventricular arrhythmias and systemic embolic events, although some patients have an asymptomatic form. NCM is commonly diagnosed by echocardiography, but contrast ventriculography, CT and MRI can also be used. Here we present a case of left ventricle NCM, manifested after respiratory infection, in a pregnant patient with congenital thrombophilia and a history of myocardial infarction.
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Affiliation(s)
- Elena A Kochmareva
- Hospital Therapy No. 1 Department, Pirogov Russian National Research Medical University, Moscow, Russian Federation
| | - Valentin A Kokorin
- Hospital Therapy No. 1 Department, Pirogov Russian National Research Medical University, Moscow, Russian Federation
| | | | - Nadejda V Khokhlova
- City Clinical Hospital No. 15 named after O.M. Filatov, Moscow, Russian Federation
| | - Argishti G Vardanyan
- Hospital Therapy No. 1 Department, Pirogov Russian National Research Medical University, Moscow, Russian Federation
| | - Ilya A Kokorin
- Hospital Therapy No. 1 Department, Pirogov Russian National Research Medical University, Moscow, Russian Federation
| | - Dmitry A Doroshenko
- City Clinical Hospital No. 15 named after O.M. Filatov, Moscow, Russian Federation
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