Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology Effect of Cardiac Resynchronization Therapy on Right Ventricular Function during Rest and Exercise, as Assessed by Radionuclide Angiography, and on NT-proBNP levels Cinzia Valzaniaa, Mauro Biffia, Rachele Bonfigliolib, Francesco Fallania, Cristian Martignania, Igor Diembergera, Matteo Ziacchia, Jessica Frisonia, Luciana Tomasia, Stefano Fantib, Claudio Rapezzia, Giuseppe Borianic aDepartment of Cardiology, S.Orsola Malpighi Hospital, University of Bologna, Bologna, Italy; bDepartment of Nuclear Medicine, S.Orsola Malpighi Hospital, University of Bologna, Bologna, Italy; cDivision of Cardiology, Modena University Hospital, University of Modena and Reggio Emilia, Modena, Italy. Copyright American Society of Nuclear Cardiology

Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology BACKGROUND 1- Cardiac resynchronization therapy (CRT) can improve left ventricular (LV) contractility. However, little is known on the effects of CRT on right ventricular (RV) function. 2- So far, the effects of CRT on RV function under exercise conditions have not been well characterized. 3- Aim of the study was to investigate mid-term effects of CRT on RV function and dyssynchrony, as assessed by Tc99m radionuclide angiography, at rest and during exercise, and neurohormonal response, expressed by N-terminal pro-brain natriuretic peptide (NT-proBNP). Copyright American Society of Nuclear Cardiology

Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology METHODS Study type: Prospective/observational. Study subjects: heart failure patients with non ischemic dilated cardiomyopathy undergoing CRT Study endpoints: Effects of CRT on RV function and dyssynchrony at mid-term follow-up Effects of CRT on NT-proBNP Study variables: RV ejection fraction and dyssynchrony, LV ejection fraction and dyssynchrony, NT-proBNP Copyright American Society of Nuclear Cardiology

Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology RESULTS Variations in biventricular function and dyssynchrony at rest and during exercise in patients with impaired and preserved right ventricular function, respectively, at different time points. Copyright American Society of Nuclear Cardiology

Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology RESULTS Variations in NT-proBNP in patients with impaired and preserved right ventricular function, respectively, at baseline and after 3 months. Copyright American Society of Nuclear Cardiology

Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology CONCLUSIONS 1- In patients with non-ischemic dilated cardiomyopathy and impaired baseline RV function, undergoing CRT treatment, a mid-term improvement in RVEF and RV dyssynchrony, at rest as well as during exercise, may be observed by radionuclide angiography. 2- The improvement in RVEF was correlated with the decrease in NT-proBNP, showing a favorable impact on neurohormonal balance. 3- RV dysfunction should not be per se a primary criterion for excluding candidacy to CRT in heart failure patients who fulfill evidence-based eligibility for CRT treatment. Copyright American Society of Nuclear Cardiology