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Pulmonary perfusion and NYHA classification improve after cardiac resynchronization therapy

BACKGROUND: Evaluation of cardiac resynchronization therapy (CRT) often includes New York Heart Association (NYHA) classification, and echocardiography. However, these measures have limitations. Perfusion gradients from ventilation/perfusion single-photon emission computed tomography (V/P SPECT) are...

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Autores principales: Al-Mashat, Mariam, Borgquist, Rasmus, Carlsson, Marcus, Arheden, Håkan, Jögi, Jonas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9834347/
https://www.ncbi.nlm.nih.gov/pubmed/34750725
http://dx.doi.org/10.1007/s12350-021-02848-8
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author Al-Mashat, Mariam
Borgquist, Rasmus
Carlsson, Marcus
Arheden, Håkan
Jögi, Jonas
author_facet Al-Mashat, Mariam
Borgquist, Rasmus
Carlsson, Marcus
Arheden, Håkan
Jögi, Jonas
author_sort Al-Mashat, Mariam
collection PubMed
description BACKGROUND: Evaluation of cardiac resynchronization therapy (CRT) often includes New York Heart Association (NYHA) classification, and echocardiography. However, these measures have limitations. Perfusion gradients from ventilation/perfusion single-photon emission computed tomography (V/P SPECT) are related to left-heart filling pressures and have been validated against invasive right-heart catheterization. The aim was to assess if changes in perfusion gradients are associated with improvements in heart failure (HF) symptoms after CRT, and if they correlate with currently used diagnostic methods in the follow-up of patients with HF after receiving CRT. METHODS AND RESULTS: Nineteen patients underwent V/P SPECT, echocardiography, NYHA classification, and the quality-of-life scoring system “Minnesota living with HF” (MLWHF), before and after CRT. CRT caused improvement in perfusion gradients from V/P SPECT which were associated with improvements in NYHA classification (P = .0456), whereas improvements in end-systolic volume (LVESV) from echocardiography were not. After receiving CRT, the proportion of patients who improved was lower using LVESV (n = 7/19, 37%) than perfusion gradients (n = 13/19, 68%). Neither change in perfusion gradients nor LVESV was associated with changes in MLWHF (P = 1.0, respectively). CONCLUSIONS: Measurement of perfusion gradients from V/P SPECT is a promising quantitative user-independent surrogate measure of left-sided filling pressure in the assessment of CRT response in patients with HF. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12350-021-02848-8.
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spelling pubmed-98343472023-01-13 Pulmonary perfusion and NYHA classification improve after cardiac resynchronization therapy Al-Mashat, Mariam Borgquist, Rasmus Carlsson, Marcus Arheden, Håkan Jögi, Jonas J Nucl Cardiol Original Article BACKGROUND: Evaluation of cardiac resynchronization therapy (CRT) often includes New York Heart Association (NYHA) classification, and echocardiography. However, these measures have limitations. Perfusion gradients from ventilation/perfusion single-photon emission computed tomography (V/P SPECT) are related to left-heart filling pressures and have been validated against invasive right-heart catheterization. The aim was to assess if changes in perfusion gradients are associated with improvements in heart failure (HF) symptoms after CRT, and if they correlate with currently used diagnostic methods in the follow-up of patients with HF after receiving CRT. METHODS AND RESULTS: Nineteen patients underwent V/P SPECT, echocardiography, NYHA classification, and the quality-of-life scoring system “Minnesota living with HF” (MLWHF), before and after CRT. CRT caused improvement in perfusion gradients from V/P SPECT which were associated with improvements in NYHA classification (P = .0456), whereas improvements in end-systolic volume (LVESV) from echocardiography were not. After receiving CRT, the proportion of patients who improved was lower using LVESV (n = 7/19, 37%) than perfusion gradients (n = 13/19, 68%). Neither change in perfusion gradients nor LVESV was associated with changes in MLWHF (P = 1.0, respectively). CONCLUSIONS: Measurement of perfusion gradients from V/P SPECT is a promising quantitative user-independent surrogate measure of left-sided filling pressure in the assessment of CRT response in patients with HF. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12350-021-02848-8. Springer International Publishing 2021-11-08 2022 /pmc/articles/PMC9834347/ /pubmed/34750725 http://dx.doi.org/10.1007/s12350-021-02848-8 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Al-Mashat, Mariam
Borgquist, Rasmus
Carlsson, Marcus
Arheden, Håkan
Jögi, Jonas
Pulmonary perfusion and NYHA classification improve after cardiac resynchronization therapy
title Pulmonary perfusion and NYHA classification improve after cardiac resynchronization therapy
title_full Pulmonary perfusion and NYHA classification improve after cardiac resynchronization therapy
title_fullStr Pulmonary perfusion and NYHA classification improve after cardiac resynchronization therapy
title_full_unstemmed Pulmonary perfusion and NYHA classification improve after cardiac resynchronization therapy
title_short Pulmonary perfusion and NYHA classification improve after cardiac resynchronization therapy
title_sort pulmonary perfusion and nyha classification improve after cardiac resynchronization therapy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9834347/
https://www.ncbi.nlm.nih.gov/pubmed/34750725
http://dx.doi.org/10.1007/s12350-021-02848-8
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