Determinants of left ventricular mechanical dyssynchrony in patients submitted to myocardial perfusion imaging: A cardiac CZT study View Full Text


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Article Info

DATE

2016-08

AUTHORS

Alessia Gimelli, Riccardo Liga, Assuero Giorgetti, Brunella Favilli, Emilio Maria Pasanisi, Paolo Marzullo

ABSTRACT

BACKGROUND: An interaction between coronary anatomy, myocardial perfusion, and left ventricular (LV) functional parameters in the development of mechanical LV dyssynchrony (LVD) has been suggested. This study examined the correlates of LVD in a large sample size of patients with known or suspected coronary artery disease (CAD) using cadmium-zinc-telluride camera. METHODS: Six-hundred and fifty-seven consecutive patients who underwent myocardial perfusion imaging (MPI) and coronary angiography were included. Coronary stenosis >70% was considered significant. LV perfusion and functional parameters were computed from MPI images. The presence of significant LVD was evaluated by phase standard deviation and histogram bandwidth. RESULTS: 415/657 (63%) patients had significant CAD. LVD was present in 247 (38%) patients and was associated with the presence of a higher CAD burden (P < .001), more impaired measures of LV perfusion (P < .001), contractile function (P < .001), and larger LV volumes (P < .001). By multivariate analysis, the LV end-systolic volume index (P < .001) and ischemic burden (P < .001) were the strongest predictors of LVD independent of CAD extent and LV systolic dysfunction. CONCLUSIONS: LVD is frequent in patients undergoing MPI for suspected or known CAD. Its presence is independent of CAD burden and LV systolic dysfunction, but is dependent on the presence of myocardial perfusion abnormalities and LV end-systolic volume. More... »

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References to SciGraph publications

  • 2012-08. Alternative methods for the assessment of mechanical dyssynchrony using phase analysis of gated single photon emission computed tomography myocardial perfusion imaging in THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING
  • 2014-12. Relation of early post-stress left ventricular dyssynchrony and the extent of angiographic coronary artery disease in JOURNAL OF NUCLEAR CARDIOLOGY
  • 2016-10. Influence of cardiac stress protocol on myocardial perfusion imaging accuracy: The role of exercise level on the evaluation of ischemic burden in JOURNAL OF NUCLEAR CARDIOLOGY
  • 2012-03. Ventricular dyssynchrony assessed by gated myocardial perfusion SPECT using a geometrical approach: a feasibility study in EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
  • 2011-02. Optimal left ventricular lead position assessed with phase analysis on gated myocardial perfusion SPECT in EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
  • 2010-11. Ultrafast assessment of left ventricular dyssynchrony from nuclear myocardial perfusion imaging on a new high-speed gamma camera in EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
  • 2009-06. Cardiac resynchronization therapy evaluated by myocardial scintigraphy with 99mTc-MIBI: changes in left ventricular uptake, dyssynchrony, and function in EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
  • 2014-05. Association between left ventricular regional sympathetic denervation and mechanical dyssynchrony in phase analysis: a cardiac CZT study in EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
  • 2005-11. Onset of left ventricular mechanical contraction as determined by phase analysis of ECG-gated myocardial perfusion SPECT imaging: Development of a diagnostic tool for assessment of cardiac mechanical dyssynchrony in JOURNAL OF NUCLEAR CARDIOLOGY
  • 2013-12. Gated SPECT evaluation of left ventricular function using a CZT camera and a fast low-dose clinical protocol: comparison to cardiac magnetic resonance imaging in EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
  • 2010-06. Relation of left-ventricular dyssynchrony by phase analysis of gated SPECT images and cardiovascular events in patients with implantable cardiac defibrillators in JOURNAL OF NUCLEAR CARDIOLOGY
  • 2015-02. Does perfusion pattern influence stress-induced changes in left ventricular mechanical dyssynchrony on thallium-201-gated SPECT myocardial perfusion imaging? in JOURNAL OF NUCLEAR CARDIOLOGY
  • Identifiers

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    http://scigraph.springernature.com/pub.10.1007/s12350-015-0247-8

    DOI

    http://dx.doi.org/10.1007/s12350-015-0247-8

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1036648920

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/26338425


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        "description": "BACKGROUND: An interaction between coronary anatomy, myocardial perfusion, and left ventricular (LV) functional parameters in the development of mechanical LV dyssynchrony (LVD) has been suggested. This study examined the correlates of LVD in a large sample size of patients with known or suspected coronary artery disease (CAD) using cadmium-zinc-telluride camera.\nMETHODS: Six-hundred and fifty-seven consecutive patients who underwent myocardial perfusion imaging (MPI) and coronary angiography were included. Coronary stenosis >70% was considered significant. LV perfusion and functional parameters were computed from MPI images. The presence of significant LVD was evaluated by phase standard deviation and histogram bandwidth.\nRESULTS: 415/657 (63%) patients had significant CAD. LVD was present in 247 (38%) patients and was associated with the presence of a higher CAD burden (P\u00a0<\u00a0.001), more impaired measures of LV perfusion (P\u00a0<\u00a0.001), contractile function (P\u00a0<\u00a0.001), and larger LV volumes (P\u00a0<\u00a0.001). By multivariate analysis, the LV end-systolic volume index (P\u00a0<\u00a0.001) and ischemic burden (P\u00a0<\u00a0.001) were the strongest predictors of LVD independent of CAD extent and LV systolic dysfunction.\nCONCLUSIONS: LVD is frequent in patients undergoing MPI for suspected or known CAD. Its presence is independent of CAD burden and LV systolic dysfunction, but is dependent on the presence of myocardial perfusion abnormalities and LV end-systolic volume.", 
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