Prognostic value of ventricular mechanical dyssynchrony in patients with left ventricular aneurysm: A comparative study
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Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, Beijing, China Department of Nuclear Medicine, Zibo Central Hospital, Zibo, Shandong Province, China Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, Hebei Province, China Department of Nuclear Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, and National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
Received Jun 13, 2020; accepted Aug 11, 2020 doi:10.1007/s12350-020-02343-6
Background. The prognostic value of left ventricular (LV) mechanical dyssynchrony (MD) in patients with LV aneurysm (LVA) is unclear. This study aimed to investigate the long-term prognostic value of LVMD in LVA patients. Methods. 92 consecutive patients who underwent 99mTc-sestamibi-gated SPECT myocardial perfusion imaging (GSPECT) were retrospectively analyzed and followed-up for a median of 63 months (range, 1-73 months). LV function and histogram bandwidth (BW) were analyzed by QGS software. LVMD was defined by ROC analysis. Cardiac death was defined as the primary endpoint, and the composite of cardiac deaths and severe or acute heart failure (MACE) as the secondary endpoint. Results. The annual cardiac mortality rate of LVA patients with LVMD and treated by surgical therapy was significantly lower than those treated by medical therapy (2.40% vs. 6.40%, P < .05) but not annual MACE rate (6.61% vs. 10.06%, P > .05). In patients without LVMD, no significant difference in survival and MACE-free survival between medical and surgical treatment. In addition, the occurrence of LVMD is related to the worsen cardiac outcome in terms of MACE and cardiac death, independent of the treatment methods. BW was an independent predictor for MACE (HR 1.010, P < .01) and LVEF (HR .928, P < .05) was an Xia Lu and Min Zhao have contributed equally to the manuscript. The authors of this article have provided a PowerPointfile, available for download at SpringerLink, which summarises thecontents of the paper and is free for re-use at meetings andpresentations. Search for the article DOI on SpringerLink.com. Funding This work was supported by National Natural Science Foundation of China (81071177, 81871377, 81571717) and Capital Characteristic Clinical Application Research (Z181100001718071).
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12350-020-02343-6) contains supplementary material, which is available to authorized users. Reprint requests: Xiaoli Zhang, MD, PhD, Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, No. 2, Anzhen Road, Chaoyang District, Beijing100029,
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