News | September 18, 2007

Ischemic HF Patients Respond Better to PET-guided CRT Lead Placement

September 18, 2007- With PET-guided lead placement, cardiac resynchronization therapy (CRT) can achieve significant clinical improvement in patients with severe ischemic heart failure, even in the presence of extensive scarring, reported investigators at the American Society of Nuclear Cardiology meeting, held in San Diego, CA, from September 6 – 9.

The preliminary study found that two-thirds of patients responded to therapy, despite evidence that CRT works only in patients with nonischemic heart failure, indicated Lucie Riedlbauchova, M.D., the Institute for Clinical and Experimental Medicine in Prague, Czech Republic.

"Our results show that CRT-associated reverse remodeling can be expected even in patients with extensive left ventricular scarring," said Dr. Riedlbauchova. "Using PET to place CRT leads remotely from the scar is associated with a more sizeable treatment effect."

The study involved 66 CRT patients with documented stenosis of 60 percent or more in at least one coronary artery (or a history of myocardial infarction), who received PET exams using both rubidium-82 perfusion imaging and 18F-FDG viability assessment prior to CRT implantation. The median follow-up was 16 months.
According to investigaors, lead placement and pacing remotely from scar area led to significant improvement in NYHA classification and to reverse remodeling. Myocardial hibernation or ischemia at the site of pacing did not affect the therapeutic impact of CRT.
The nonresponse rate was 35 percent, despite the presence of extensive left ventricular scarring in the patient population. Twenty patients died during follow-up, 14 of whom were nonresponders. Among the patients who died, the time from CRT implantation to death was significantly longer in patients who had responded to resynchronization therapy (34 months versus 9 months in nonresponders, P=0.01) and in patients who had scarring that involved less than 25 percent of the left ventricle (P=0.01 versus more extensive scarring).

For more information:

Related Content

Subtle Medical Receives FDA Clearance, CE Mark for SubtlePET
Technology | PET Imaging | December 05, 2018
Subtle Medical announced 510(k) clearance from the U.S. Food and Drug Administration (FDA) to market SubtlePET. Subtle...
Researchers Trace Parkinson's Damage in the Heart
News | PET Imaging | July 17, 2018
A new way to examine stress and inflammation in the heart will help Parkinson’s researchers test new therapies and...
Novel PET Tracer Detects Small Blood Clots

PET images (MIP 0-60 min) of three Cynomolgus monkeys. Strong signals are detected at the sites where inserted catheters had roughened surfaces. Almost no other background signal is visible. Only accumulation in the gallbladder becomes visible at the bottom of the image. Credit: Piramal Imaging GmbH, Berlin Germany.

News | PET Imaging | July 07, 2017
Blood clots in veins and arteries can lead to heart attack, stroke and pulmonary embolism, which are major causes of...
PET imaging, atherosclerotic plaque, inflammation, Ga-68-pentixafor, Technishe Universitat Munchen, Germany

Note the high uptake of Ga-68-pentixafor on multi-planar reconstructions in the organs expressing CXCR4 such as the spleen (red arrows) and adrenal glands (yellow arrows), which was nearly completely blocked by the pre-injection of AMD 3100, a potent CXCR4 inhibitor. Strong accumulation of Ga-68-pentixafor was also found in the kidneys (asterisks) reflecting the renal clearance of the tracer. In addition, high, focal activities were detected in the abdominal aorta (red arrowheads) and right carotid artery (orange arrowheads) of atherosclerotic rabbits, whereas no significant signal could be detected in the non-injured left carotid artery (white arrowheads) of atherosclerotic and control rabbits, as well as in the abdominal aorta and right carotid artery of control rabbits. Furthermore, focal activities detected with PET in atherosclerotic plaques of the abdominal aorta and the right carotid artery decreased significantly when the same rabbit was re-imaged after blocking CXCR4 receptors. Image courtesy of Fabien Hyafil, M.D., Ph.D., Department of Nuclear Medicine, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany

News | PET Imaging | March 03, 2017
In the featured article of the March 2017 issue of The Journal of Nuclear Medicine, researchers demonstrate that a new...
ASNC, SNMMI, position statement, myocardial perfusion PET, coronary artery disease
News | PET Imaging | September 01, 2016
September 1, 2016 — The American Society for Nuclear Cardiology (ASNC) and the Society of...
cardiac PET, myocardial perfusion, PET-CT, cardiac perfusion

A PET-CT cardiac perfusion exam from a Siemens Biograph scanner. The black and white areas of the image show the CT imaging of the anatomy. The colored portion shows the PET overlay on the myocardium and is color-coded to show tracer uptake values. This can show areas of the heart muscle where there are perfusion defects cause by infarcts or coronary artery blockages due to a heart attack and help determine the severity of the ischemia.

Feature | PET Imaging | June 03, 2016 | Dave Fornell
Positron emission tomography (PET) is a nuclear imaging technology (also referred to as molecular imaging) that enabl
blood clot detection, single scan, rats, radionuclides, Peter Caravan, whole body

The whole body of a rat can be imaged for blood clots with one PET scan (which is overlaid here on an MRI image) using the FBP8 probe. Arrow points to a blood clot. Image courtesy of Peter Caravan, Ph.D.

News | PET Imaging | September 23, 2015
September 23, 2015 — New research de