Phase analysis in patients with reversible perfusion defects and normal coronary arteries at angiography
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ORIGINAL ARTICLE
Phase analysis in patients with reversible perfusion defects and normal coronary arteries at angiography Alper O. Karacalioglu • S¸ evket Balta • Ozdes Emer • Sait Demirkol • Turgay Celik Mehmet Ozguven
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Received: 17 December 2012 / Accepted: 6 February 2013 / Published online: 23 February 2013 Ó The Japanese Society of Nuclear Medicine 2013
Abstract Objective A count-based new technique from gated myocardial perfusion single-photon emission tomography (gMPS) was developed to allow the phase analysis providing information about the left ventricular (LV) regional discordance in contractility which is a measure of LV dyssynchrony. Since the phase analysis provides data for evaluating the dyssynchronous LV contraction, it has an important role in diagnosis and management of patients with left ventricular dysfunction. The aim of the study was to assess the presence of left ventricular dyssynchrony in patients with reversible perfusion defects on gMPS scans and normal or near normal coronary arteries at angiography. Methods 32 patients (19 men, 59 %) with reversible mild perfusion defects on gMPS and normal coronary angiogram were retrospectively enrolled in the study. The peak of the phase histogram, the standard deviation of the phase distribution (PSD), the width of the band (PHB), and the symmetry and peakedness of the phase histogram, which are the assessment parameters for the LV dyssynchrony, were calculated from gMPS scans of patients by means of the phase analysis. Results Although, five quantitative variables are derived from the phase analysis of gMPS, PSD and PHB are two quantitative indices to assess LV global mechanical dyssynchrony and measurements of PSD (men 24.96 ± 7.31, women 24.26 ± 10.07) and PHB (men 70.1 ± 13.99, A. O. Karacalioglu (&) O. Emer M. Ozguven Department of Nuclear Medicine, Gu¨lhane Military Medical Academy and School of Medicine, 06018 Ankara, Turkey e-mail: [email protected]; [email protected] S¸ . Balta S. Demirkol T. Celik Department of Cardiology, Gulhane Military Medical Academy and School of Medicine, Ankara, Turkey
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women 71.0 ± 30.4) were significantly higher than the those reported in the literature (p \ 0.001). No significant differences in gMPS phase analysis indices were found between both sexes except kurtosis. Conclusion As a conclusion, this study provides the phase analysis to detect LV mechanical dyssynchrony as new evidence supporting the concept that an abnormal scintigraphy finding, rather than being false-positive, may be an early marker of vasomotion changes associated with occult atherosclerosis in patients with normal coronary angiography findings. Keywords Phase analysis SPECT Gated myocardial perfusion imaging Cardiac syndrome X
Introduction Electrocardiography (ECG)-gated myocardial perfusion single-photon emission computed tomography (SPECT) of the heart is the most widely used nuclear imaging modality for diagnosis and management of coronary artery disease, since it allows simultaneous clinical assessment of
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