The prognostic significance of cardiac sympathetic activity and dyssynchrony in cardiac resynchronization therapy in ischemic and non-ischemic heart failure patients

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main source(s): Russian Foundation for Basic Research Introduction Impaired cardiac sympathetic activity and contractility are associated with poor prognosis in patients heart failure after resynchronization therapy (CRT). There few prognostic data the dyssynchrony chronic various etiologies. Purpose To examine significance scintigraphic predicting response to CRT assess differences between ischemic (IHF) non-ischemic (NIHF) failure. Methods This study included 38 (24 male; mean age 56 ± 11 years; 16 etiology), who were submitted CRT. Before all underwent 123I-metaiodobenzylguanidine (123I-MIBG) imaging evaluating: early delay mediastinum ratio (eH/M dH/M), summed MIBG Score (eSMS dSMS). Moreover gated SPECT assessments left ventricle indexes: standard deviation (SD) histogram bandwidth (HBW). In addition, blood-pool (GBPS) assessed ejection fraction (EF) stroke volume (SV) both ventricles. Results One year defined as LV ESV decreased by?15% and/or EF increase by?5%. Baseline parameters showed significant responders non-responders only NIHF patients: eH/M: 2.27 (2.02–2.41) vs. 1.64 (1.32–2.16); dH/M: 2.18 (2.11–2.19) 1.45 (1.23 – 1.61); eSMS: 7 (5-7) 15.5 (10–28.5); dSMS: 10 (10–13) 16.5 (15.5–29). Significant baseline indexes group: - SD: 54.3 (43–58) degree 65 (62–66) degree; HBW: 179.5 (140–198) 211 (208-213) degree, p < 0.054 IHF 162 (115.2–180) 115.2 (79.2–136.8) degree. Contractility RV was significantly differed EF: 54.5 (41-56) % 44.5 (37–49.5) %; SV: 80 (69-101) ml 55.5 (50–72.5) ml. According univariate logistic regression analyses SD (OR = 1.55; 95% CI 1.09-2.2; 0.5) HBW 1.13; 1.02-1.24; 0.5), well 1.11; 1.001-1.23; SV 1.07; 1.003-1.138; predictors response. group patients, dH/M 1.47; 1.08-2; 0.83; 0.73-0.95; 0.96; 0.93-0.99; predictive value terms Conclusion Scintigraphic methods can be used select Cardiac 123I-MIBG scintigraphy may patients. Whereas ECG-gated GBPS valuable