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Therapeutic Research
Abstract
Cardiac resynchronization therapy(CRT) has become an accepted therapy in patients with drug–refractory heart failure. Although it is important to identify the dyssynchrony in the left ventricle for predicting CRT response, opinions are divergent on evaluation criteria. Here we report a patient with significant intraventricular dyssynchrony identified by Three–Dimensional Quantitative Blood –pool SPECT(3D–QBS). A sixties male with ischemic cardiomyopathy, severe left ventricular dysfunction; New York Heart Association Ⅲ functional class with an ejection fraction of 20% was hospitalized for heart failure. His electrocardiogram showed left bundle branch block with a wide QRS duration(198 ms). To predict of the effectiveness of CRT, we evaluated dyssynchrony by 3D–QBS, Quantitative Gated –SPECT(QGS) and tissue doppler imaging. 3D–QBS showed significant left ventricular mechanical dyssynchrony especially septal –lateral wall delay, even though the other two inspections could not reveal it. It seemed probable that CRT has effect on him. After CRT, his symptom was improved to NYHA I. Three–Dimensional Quantitative Blood Pool SPECT might be useful to identify the dyssynchrony to predict CRT response.
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