Low septal to lateral wall 18F-FDG ratio is highly associated with mechanical dyssynchrony in non-ischemic CRT candidates
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 Thi...
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doaj-a669ece8d0344f5a8a89f5dd77f253af2020-12-13T12:18:35ZengSpringerOpenEJNMMI Research2191-219X2019-12-019111010.1186/s13550-019-0575-9Low septal to lateral wall 18F-FDG ratio is highly associated with mechanical dyssynchrony in non-ischemic CRT candidatesGanna Degtiarova0Piet Claus1Jürgen Duchenne2Marta Cvijic3Georg Schramm4Johan Nuyts5Jens-Uwe Voigt6Olivier Gheysens7Department of Imaging and Pathology, KU LeuvenDepartment of Cardiovascular Sciences, KU LeuvenDepartment of Cardiovascular Sciences, KU LeuvenDepartment of Cardiovascular Diseases, University Hospitals LeuvenDepartment of Imaging and Pathology, KU LeuvenDepartment of Imaging and Pathology, KU LeuvenDepartment of Cardiovascular Sciences, KU LeuvenDepartment of Imaging and Pathology, KU LeuvenAbstract 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.https://doi.org/10.1186/s13550-019-0575-9Mechanical dyssynchronyPerfusionMetabolismCardiac resynchronization therapyPositron emission tomography |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ganna Degtiarova Piet Claus Jürgen Duchenne Marta Cvijic Georg Schramm Johan Nuyts Jens-Uwe Voigt Olivier Gheysens |
spellingShingle |
Ganna Degtiarova Piet Claus Jürgen Duchenne Marta Cvijic Georg Schramm Johan Nuyts Jens-Uwe Voigt Olivier Gheysens Low septal to lateral wall 18F-FDG ratio is highly associated with mechanical dyssynchrony in non-ischemic CRT candidates EJNMMI Research Mechanical dyssynchrony Perfusion Metabolism Cardiac resynchronization therapy Positron emission tomography |
author_facet |
Ganna Degtiarova Piet Claus Jürgen Duchenne Marta Cvijic Georg Schramm Johan Nuyts Jens-Uwe Voigt Olivier Gheysens |
author_sort |
Ganna Degtiarova |
title |
Low septal to lateral wall 18F-FDG ratio is highly associated with mechanical dyssynchrony in non-ischemic CRT candidates |
title_short |
Low septal to lateral wall 18F-FDG ratio is highly associated with mechanical dyssynchrony in non-ischemic CRT candidates |
title_full |
Low septal to lateral wall 18F-FDG ratio is highly associated with mechanical dyssynchrony in non-ischemic CRT candidates |
title_fullStr |
Low septal to lateral wall 18F-FDG ratio is highly associated with mechanical dyssynchrony in non-ischemic CRT candidates |
title_full_unstemmed |
Low septal to lateral wall 18F-FDG ratio is highly associated with mechanical dyssynchrony in non-ischemic CRT candidates |
title_sort |
low septal to lateral wall 18f-fdg ratio is highly associated with mechanical dyssynchrony in non-ischemic crt candidates |
publisher |
SpringerOpen |
series |
EJNMMI Research |
issn |
2191-219X |
publishDate |
2019-12-01 |
description |
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. |
topic |
Mechanical dyssynchrony Perfusion Metabolism Cardiac resynchronization therapy Positron emission tomography |
url |
https://doi.org/10.1186/s13550-019-0575-9 |
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