Left ventricular (LV) dyssynchrony is an increasingly important consideration in the
evaluation and management of patients with LV systolic dysfunction. Improvements in
clinical status, LV remodeling, and survival have been demonstrated with the use of
cardiac resynchronization therapy (CRT). The current selection criteria for patients
who undergo CRT include the presence of severe LV dysfunction, significant heart failure
symptoms, and electrical dyssynchrony on surface electrocardiography (wide QRS interval).
However, up to 40% of patients who undergo CRT do not experience reductions in symptoms
or LV functional improvement. Because electrical dyssynchrony is not synonymous with
contractile or mechanical dyssynchrony, efforts have been made to more accurately
quantify mechanical dyssynchrony in the hope of improving the selection of patients
for CRT. These efforts have focused largely on echocardiographic measures of mechanical
dyssynchrony. A novel method to quantify LV mechanical dyssynchrony has been developed
using phase analysis of gated single photon-emission computed tomographic myocardial
perfusion imaging. In conclusion, this report describes potential advantages, compared
with other methods, of using myocardial perfusion imaging to evaluate patients for
CRT; reviews the method of the phase analysis technique to quantify dyssynchrony;
reviews the available evidence of its utility; and describes future directions in
research.
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Article Info
Publication History
Published online: May 09, 2008
Accepted:
March 2,
2008
Received in revised form:
March 2,
2008
Received:
February 13,
2008
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
