Capabilities of myocardial perfusion-metabolism scintigraphy for prediction of cardiac resynchronization therapy outcomes in patients with dilated cardiomyopathy

Aim: to evaluate myocardial perfusion and metabolism of the left ventricle (LV) in patients with dilated cardiomyopathy (DCMP) and to use these data for development of gamma-scintigraphic predictors of cardiac resynchronization therapy (CRT) efficacy. The study included DCMP patients (n=51) who received CRT. Before treatment, all patients underwent examination of the myocardial metabolism and perfusion by using ß-methyl-p-[123I] iodophenyl-pentadecanoic acid ( 123I-BMIPP) and 99mTc-methoxyisobutylisonitrile, respectively. The 17-segment model of the LV myocardium was used to evaluate metabolic and perfusion deficits as well as perfusion-metabolism mismatch. After 6 months of CRT, patients whose end-systolic volume (ESV) decreased by 15% and more were qualified as “responders” whereas those with ESV decrease by less than 15% were considered “nonresponders”. Groups of “responders” (n=36) and “nonresponders” (n=15) significantly differed by the sizes of perfusion defects (8.70+2.94% vs. 13.73±1.92%, p123I-BMIPP may be used as additional diagnostic criteria for selection of patients for CRT and for prediction of efficacy of this interventional method of treatment in patients with DCMP.