Electrocardiogram-Gated 18F-FDG PET/CT Hybrid Imaging in Patients with Unsatisfactory Response to Cardiac Resynchronization Therapy: Initial Clinical Results

Journal of Nuclear Medicine

Roland Tegtmeyer¹  Stephan Nekolla¹  Michael Ulbrich¹  Paul Cumming¹  Marcus Hacker¹  Peter Bartenstein¹  Stefan Kääb¹  Christoph Becker¹  Nadine Haserueck¹  Christopher Uebleis¹  Johannes Siebermair¹  Franziska Schuessler¹ 

关键词: resynchronization therapy;    gated ¹⁸F-FDG PET/CT;    phase analysis;    hybrid imaging;    nonresponder;    dyssynchrony;    ICD;   

DOI  :  10.2967/jnumed.110.078709

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

The present study aimed to distinguish responders to cardiac resynchronization therapy (CRT) from nonresponders, using electrocardiogram-gated 18F-FDG PET/CT. Methods: Seven consecutive CRT nonresponders were included in the study, along with 7 age- and sex-matched CRT responders, serving as reference material. Therapy response was defined as clinical improvement (≥1 New York Heart Association class) and evidence of reverse remodeling. Besides PET/CT, we measured brain natriuretic peptide levels and assessed dyssynchrony using transthoracic echocardiography. Results: Compared with nonresponders, CRT responders showed significant differences in the declines of left-ventricular end-systolic volume and brain natriuretic peptide and in left-ventricular dyssynchrony (global left-ventricular entropy), extent of the myocardial scar burden, and biventricular pacemaker leads positioned within viable myocardial regions. Among the nonresponders, further therapy management was guided by the PET/CT results in 4 of 7 patients. Conclusion: Cardiac hybrid imaging using gated 18F-FDG PET/CT enabled the identification of potential reasons for nonresponse to CRT therapy, which can guide subsequent therapy.

【 授权许可】

Unknown