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Publications

Journal Article Ahead of print

PubMed: 41912136 DOI: 10.1016/j.nuclcard.2026.102708

Gated SPECT Imaging of Left Ventricular Mechanical Dyssynchrony: Predictive Value in Cardiac Resynchronization Therapy Candidates.

J Nucl Cardiol

Authors: Agnieszka Stępień-Wroniecka, Wojciech Szot, Ewa Dziewięcka, Krzysztof Boczar, Andrzej Ząbek, Katarzyna Holcman, Katarzyna Graczyk, Mateusz Winiarczyk, Natalia Przytuła, Sylwia Wiśniowska-Śmiałek, Katarzyna Deleska, Paweł Rubiś, Magdalena Kostkiewicz

Affiliations

  • Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, Kraków, Poland; Department of Cardiac and Vascular Diseases, The Specialist Hospital of St. John Paul II in Cracow, Jagiellonian University Medical College, Prądnicka Street 80, 31-202 Krakow, Poland.
  • Department of Nuclear Medicine, The Specialist Hospital of St. John Paul II in Cracow, Prądnicka Street 80, 31-202 Krakow, Poland.
  • Department of Cardiac and Vascular Diseases, The Specialist Hospital of St. John Paul II in Cracow, Jagiellonian University Medical College, Prądnicka Street 80, 31-202 Krakow, Poland; Institute of Cardiology, Jagiellonian University Collegium Medicum, The Specialist Hospital of St. John Paul II in Cracow, Prądnicka Street 80, 31-202 Krakow, Poland.
  • Institute of Cardiology, Jagiellonian University Collegium Medicum, The Specialist Hospital of St. John Paul II in Cracow, Prądnicka Street 80, 31-202 Krakow, Poland; Department of Electrocardiology, The Specialist Hospital of St. John Paul II in Cracow, Institute of Cardiology, Jagiellonian University Medical College, Prądnicka Street 80, 31-202 Krakow, Poland.
  • Department of Cardiac and Vascular Diseases, The Specialist Hospital of St. John Paul II in Cracow, Jagiellonian University Medical College, Prądnicka Street 80, 31-202 Krakow, Poland; Department of Nuclear Medicine, The Specialist Hospital of St. John Paul II in Cracow, Prądnicka Street 80, 31-202 Krakow, Poland.
  • Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, Kraków, Poland; Department of Cardiac and Vascular Diseases, The Specialist Hospital of St. John Paul II in Cracow, Jagiellonian University Medical College, Prądnicka Street 80, 31-202 Krakow, Poland.
  • Department of Cardiac and Vascular Diseases, The Specialist Hospital of St. John Paul II in Cracow, Jagiellonian University Medical College, Prądnicka Street 80, 31-202 Krakow, Poland.
  • Department of Cardiac and Vascular Diseases, The Specialist Hospital of St. John Paul II in Cracow, Jagiellonian University Medical College, Prądnicka Street 80, 31-202 Krakow, Poland; Institute of Cardiology, Jagiellonian University Collegium Medicum, The Specialist Hospital of St. John Paul II in Cracow, Prądnicka Street 80, 31-202 Krakow, Poland.
  • Students Scientific Group of Cardiovascular Imaging, Department of Cardiac and Vascular Diseases, The Specialist Hospital of St. John Paul II in Cracow, Jagiellonian University Medical College, Prądnicka Street 80, 31-202 Krakow, Poland.

Abstract

BACKGROUND

Cardiac resynchronization therapy (CRT) is recommended for patients with heart failure with reduced ejection fraction (HFrEF) who meet specific electrocardiographic (ECG) criteria of electrical dyssynchrony. Gated-single-photon-emission computed tomography (G-SPECT) is an imaging method that allows for the assessment of left ventricular mechanical dyssynchrony (LVMD); however, its predictive value for CRT response remains uncertain. This study aimed to evaluate the utility of G-SPECT in identifying LVMD and predicting CRT response in patients with HFrEF.

METHODS

Patients with HFrEF and a LVEF <35% were prospectively enrolled and stratified into two groups: 60 patients CRT-eligible (Group 1) and 40 CRT-ineligible (Group 2). All patients underwent ECG, echocardiography and G-SPECT imaging at baseline and at 6-month follow-up. LVMD was assessed using G-SPECT-derived parameters: (a) histogram bandwidth (HBW), (b) phase standard deviation (PSD), and (c) phase entropy, both at rest and under stress. CRT response was evaluated based on change in LVEF.

RESULTS

At baseline, patients in Group 1 exhibited greater LVMD as assessed by both echocardiography and G-SPECT. All G-SPECT-derived parameters, along with septal-to-posterior wall motion delay on echocardiography were correlated with QRS duration. After CRT, LVMD significantly improved in Group 1. Super-response, defined as EF normalization, was observed in 11.9% of patients. G-SPECT-derived LVMD parameters, particularly rest PSD and entropy measures, were significant predictors of the favourable outcome of LVEF normalisation.

CONCLUSIONS

LVMD parameters obtained from G-SPECT were significantly correlated with electrical dyssynchrony as measured by QRS duration. Following CRT implantation, LVMD improved in parallel with increases in LVEF.

MeSH

Predictive Value Of Tests, Cardiac Resynchronization Therapy, Tomography, Emission-Computed, Single-Photon, Heart Failure, Systolic, Echocardiography, Therapeutics, Electrocardiography