Impact of Left Ventricular Scar Burden and Cardiac Dissynchrony on CRT Efficacy: A Single-Center Retrospective Observational Study

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Objective: To assess the correlations of left ventricular scar burden and cardiac dyssynchrony with CRT efficacy. Methods: We analyzed the left ventricular scar burden and cardiac dyssynchrony evaluated by SPECT-MPI-PA in 31 CRT patients, who were divided into a CRT-response group (18 pts, 8 males) and a CRT-nonresponse group (13 pts, 10 males). The CRT response is defined as the LVEF improvement by more than 5% or no rehospitalization. The nonresponse is defined as the LVEF improvement by less than 5% or at least one admission to hospital. The LV scar burden and cardiac dyssynchrony were determined by SPECT-MPI-PA. The cardiac dyssynchrony parameters include phase standard deviation (PSD) and phase histogram bandwidth (PHB). Results: Thirty one patients were followed up with an average of 23 months. The average LVEF improvement was 16.0% and −1.2% in response and nonresponse group, respectively (p<0.01). The average of PSD and PHB was 25.8 degrees and 80.7 degrees in response group, while 55.4 degrees and 177.2 degrees in nonresponse group (p<0.01). The scar burden was 27.7% and 39.2% in response group and nonresponse group, respectively (p<0.05). Conclusion: Cardiac dyssynchrony and myocardial scar burden assessed by SPECT-MPI-PA is associated with CRT efficacy, which may provide identifications of CRT responders.