Left ventricular systolic and diastolic dyssynchrony assessed by phase analysis of gated SPECT myocardial perfusion imag
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ORIGINAL ARTICLE
Left ventricular systolic and diastolic dyssynchrony assessed by phase analysis of gated SPECT myocardial perfusion imaging: a comparison with speckle tracking echocardiography Tang-Ho Hsu • Wen-Sheng Huang • Chien-Cheng Chen Guang-Uei Hung • Tsai-Chou Chen • Chia-Hung Kao • Ji Chen
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Received: 8 May 2013 / Accepted: 10 June 2013 Ó The Japanese Society of Nuclear Medicine 2013
Abstract Objective The objective of this study was to compare left ventricular (LV) systolic and diastolic dyssynchrony parameters measured by phase analysis on gated singlephoton emission computed tomography (SPECT) myocardial perfusion imaging (MPI) with those measured by speckle tracking echocardiography (STE). Materials and methods Two patient groups were enrolled from the Chang Bing Show Chwan Memorial Hospital. The systolic group consisted of patients with reduced LV ejection fraction (LVEF) of \50 % as assessed by routine echocardiography. The diastolic group consisted of patients with normal LVEF ([50 %) and diastolic dysfunction according to routine echocardiography (E/A \1, E/E0 [8). LV systolic and diastolic dyssynchrony parameters were calculated using STE as the maximal peak-time delay
T.-H. Hsu C.-C. Chen T.-C. Chen Department of Cardiology, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan W.-S. Huang Department of Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan G.-U. Hung (&) Department of Nuclear Medicine, Chang Bing Show Chwan Memorial Hospital, 6 Lukon Road, Lukong Town, 505 Changhua, Taiwan e-mail: [email protected]
between peak radial strains of two opposing LV walls and as the standard deviation of the time to peak radial strains in 6 mid-LV segments. All of the patients had gated SPECT MPI within 6 ± 11 days post STE. Phase analysis was performed on the resting gated SPECT MPI images to calculate systolic and diastolic phase standard deviation and phase histogram bandwidth as markers of LV systolic and diastolic dyssynchrony, respectively. Results Fifty-two consecutive patients (40 men, mean age = 66 ± 13 years, LVEF = 34.4 ± 10.2 %) were enrolled in the systolic group, whereas 30 consecutive patients (15 men, mean age = 69 ± 11 years, LVEF = 72.3 ± 4.7 %, E/A all \1, E/E0 = 11.7 ± 2.2) were enrolled in the diastolic group. LV systolic and diastolic dyssynchrony parameters measured by phase analysis of gated SPECT MPI and STE were correlated well in both systolic and diastolic groups, respectively. Conclusion Phase analysis on gated SPECT MPI showed good correlations with STE and is suitable for the assessment of LV systolic and diastolic dyssynchrony. As assessed with the phase analysis and STE techniques, the patients with severe LV systolic dysfunction had severe LV systolic dyssynchrony, but the patients with LV diastolic dysfunction were not necessarily with LV diastolic dyssynchrony, indicating that the LV diastolic dyssynchrony parameters characterized independent mechanisms of LV regional diastolic function. Keywords LV dyssynchrony Phase analysis Gated SPECT
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