Evaluation of mechanical dyssynchrony and myocardial perfusion using phase analysis of gated SPECT imaging in patients with left ventricular dysfunction.

Published

Journal Article

BACKGROUND: Using phase analysis of gated single photon emission computed tomography (SPECT) imaging, we examined the relation between myocardial perfusion, degree of electrical dyssynchrony, and degree of SPECT-derived mechanical dyssynchrony in patients with left ventricular (LV) dysfunction. METHODS AND RESULTS: We retrospectively examined 125 patients with LV dysfunction and ejection fraction of 35% or lower. Fourier analysis converts regional myocardial counts into a continuous thickening function, allowing resolution of phase of onset of myocardial thickening. The SD of LV phase distribution (phase SD) and histogram bandwidth describe LV phase dispersion as a measure of dyssynchrony. Heart failure (HF) patients with perfusion abnormalities have higher degrees of dyssynchrony measured by median phase SD (45.5 degrees vs 27.7 degrees, P < .0001) and bandwidth (117.0 degrees vs 73.0 degrees, P = .0006). HF patients with prolonged QRS durations have higher degrees of dyssynchrony measured by median phase SD (54.1 degrees vs 34.7 degrees, P < .0001) and bandwidth (136.5 degrees vs 99.0 degrees, P = .0005). Mild to moderate correlations exist between QRS duration and phase analysis indices of phase SD (r = 0.50) and bandwidth (r = 0.40). Mechanical dyssynchrony (phase SD >43 degrees) was 43.2%. CONCLUSIONS: HF patients with perfusion abnormalities or prolonged QRS durations have higher degrees of mechanical dyssynchrony. Gated SPECT myocardial perfusion imaging can quantify myocardial function, perfusion, and dyssynchrony and may help in evaluating patients for cardiac resynchronization therapy.

Full Text

Duke Authors

Cited Authors

  • Trimble, MA; Borges-Neto, S; Honeycutt, EF; Shaw, LK; Pagnanelli, R; Chen, J; Iskandrian, AE; Garcia, EV; Velazquez, EJ

Published Date

  • September 2008

Published In

Volume / Issue

  • 15 / 5

Start / End Page

  • 663 - 670

PubMed ID

  • 18761269

Pubmed Central ID

  • 18761269

Electronic International Standard Serial Number (EISSN)

  • 1532-6551

Digital Object Identifier (DOI)

  • 10.1016/j.nuclcard.2008.06.007

Language

  • eng

Conference Location

  • United States