Risk stratification of patients with prior myocardial infarction and advanced left ventricular dysfunction by gated myocardial perfusion SPECT imaging

Morishima, Itsuro; Sone, Toshio; Tsuboi, Hideyuki; Mukawa, Hiroaki; Uesugi, Masayuki; Morikawa, Shuji; Takagi, Kensuke; Niwa, Toshimitsu; Morita, Yasuhiro; Murakami, Ryuichiro; Numaguchi, Yasushi; Murohara, Toyoaki; Okumura, Kenji

doi:10.1016/j.nuclcard.2008.03.009

Cited by 28 publications

(12 citation statements)

References 18 publications

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“…Myocardial scar is an important contributor to LV dysfunction in HF patients and has been shown to predict arrhythmic events. 13 However, in this study of patients with CRT and BiV pacing for at least 1 year, myocardial scar on SPECT was not an independent predictor of arrhythmic events. Myocardial scar likely exerts its pro-arrhythmic effect in more than one way-providing a focus of electrical vulnerability and also by promoting remodeling (measured as change in LV volume, ejection fraction, and QRS duration).…”

Section: See Related Article Pp 1282-1288contrasting

confidence: 58%

Myocardial substrate after cardiac resynchronization therapy and the risk of ventricular arrhythmias

Malhotra

2017

Journal of Nuclear Cardiology

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Section: See Related Article Pp 1282-1288contrasting

confidence: 58%

Myocardial substrate after cardiac resynchronization therapy and the risk of ventricular arrhythmias

Malhotra

2017

Journal of Nuclear Cardiology

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“…Some studies have shown that scar burden is a more powerful predictor of total mortality [63,64] and sudden cardiac death than LVEF. In 106 participants of the Multicentre Automatic Defibrillator Implantation Trial II (MADIT-II), the size of myocardial perfusion defects at rest on SPECT emerged as the strongest predictor of lethal arrhythmias over a follow-up of 30 months [65]. Using…”

Section: Scar and Arrhythmiasmentioning

confidence: 99%

Current and future role of cardiovascular magnetic resonance in cardiac resynchronization therapy

Leyva

Foley

2011

Heart Fail Rev

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Cardiac resynchronization therapy (CRT) has revolutionized the treatment of selected patients with systolic heart failure. It is well recognized, however, that the symptomatic response to and the outcome of CRT is highly variable. The degree of pre-implant mechanical dyssynchrony and the extent as well as the localization of myocardial scarring are known to contribute to this variability. Cardiovascular magnetic resonance (CMR) is the gold-standard imaging modality for the assessment of myocardial structure and function. Recently, CMR has also been shown to be useful in assessing cardiac dyssynchrony and in guiding left ventricular lead deployment away from scarred myocardium. This review explores the current role of CMR in risk stratification and in guiding LV lead deployment. The potential of CMR in identifying the arrhythmogenic substrate is also discussed.

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“…Morishima et al (8) reported that single-photon emission computed tomography (SPECT) myocardial perfusion defect size at rest was the strongest predictor of lethal arrhythmic events over 30 months of follow-up among 106 patients with MADIT II (Multicenter Automatic Defibrillator Implantation Trial II) criteria for ICD placement. Cardiac magnetic resonance (CMR) with late gadolinium enhancement has been used to demonstrate myocardial scar in patients with nonischemic and ischemic cardiomyopathy.…”

Section: Myocardial Scarmentioning

confidence: 99%

Will Imaging Assist in the Selection of Patients With Heart Failure for an ICD?

Gerson

Abdallah

Muth

et al. 2010

JACC: Cardiovascular Imaging

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Sudden cardiac death remains the leading cause of death in the U.S. A left ventricular ejection fraction (LVEF)<30% to 35% identifies a population of patients at increased risk for sudden cardiac death. Once identified, an implantable cardioverter-defibrillator (ICD) is effective in reducing the occurrence of sudden cardiac death. Yet in a substantial proportion of patients who receive an ICD based on reduced LVEF, the device never delivers therapy. Furthermore, the majority of patients who die suddenly do not qualify for ICD placement under current LVEF-based criteria in the guidelines. This review considers the potential role of cardiac imaging in improving the selection of patients most likely to benefit from an ICD. The presence of myocardial scar and/or unrevascularized myocardial ischemia provides an important substrate for the occurrence of potentially fatal ventricular arrhythmias. The presence of clinical heart failure further increases the risk of ventricular arrhythmia. The sympathetic nervous system provides an important trigger for major arrhythmic events, both through global overactivity and through regional heterogeneity of sympathetic activity. A mismatch of myocardial perfusion and innervation may pose a particularly great risk. Imaging modalities provide unique opportunities to investigate the anatomic and pathophysiologic substrates, as well as the triggering effects of cardiac sympathetic innervation. Combining imaging and electrophysiologic modalities offers promise for improved accuracy in future selection of patients with heart failure for ICD placement.

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Risk stratification of patients with prior myocardial infarction and advanced left ventricular dysfunction by gated myocardial perfusion SPECT imaging

Cited by 28 publications

References 18 publications

Myocardial substrate after cardiac resynchronization therapy and the risk of ventricular arrhythmias

Myocardial substrate after cardiac resynchronization therapy and the risk of ventricular arrhythmias

Current and future role of cardiovascular magnetic resonance in cardiac resynchronization therapy

Will Imaging Assist in the Selection of Patients With Heart Failure for an ICD?

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