The evaluation of left ventricular dyssynchrony in hypertensive patients with a preserved systolic function undergoing g
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ORIGINAL ARTICLE
The evaluation of left ventricular dyssynchrony in hypertensive patients with a preserved systolic function undergoing gated SPECT myocardial perfusion imaging Maryam Alvandi1 · Zahra Shaghaghi1 · Vahid Aryafar1 · Farnaz Fariba2 · Zahra Sanaei3 Received: 7 May 2019 / Accepted: 17 September 2019 © The Japanese Society of Nuclear Medicine 2019
Abstract Background Hypertension as a known risk factor for cardiovascular diseases can result in left ventricular dyssynchrony (LVD) leading to uncoordinated contraction. The aim of our study was to evaluate whether systolic mechanical dyssynchrony measured by phase analysis of gated single-photon emission computed tomography (SPECT) imaging occurs in hypertensive patients with a low risk for coronary artery disease and a normal ejection fraction and its possible relationships with severity of hypertension and the influence of antihypertensive treatments. Methods A total of 466 patients (328 females and 138 males, with a mean age of 59.62 ± 10.27 years) who had a low risk factor for coronary artery disease, a normal perfusion study and, a normal ejection fraction were included of which 408 was hypertensive and 58 normotensive. Phase analysis parameters (derived using QGS software) were compared in patients with and without hypertension. Using different statistical methods, relationship between derived phase analysis indices (PSD, PHB) for LVD and amount of blood pressure and antihypertensive drugs consumption were evaluated. Results The prevalence of LVD in patients with hypertension was 63.2% (n = 258), while it was 6.9% in the normotensive group. The mean values of PSD and PHB were higher in hypertensive patients than normotensive ones (12.55 vs. 5.8 and 39.24 vs. 21.12), respectively, so that, statistically significant differences were found between the patients with and without hypertension (p 130 on the day of the study (3), in the absence of any other risk factor for coronary artery disease. All of them had to have recent (within 2 month) normal echocardiography indices including a normal global left ventricular ejection fraction (LVEF ≥ 50%) in particular and without any considerable motion abnormality or valvular heart disease. 753 patients met the criteria at this stage. After considering MPI results, patients with normal resting Table 1 Demographic and baseline GSPECT data of the study groups
and post-stress MPI remained in the study (n = 448). A normal MPI study was defined as the absence of any significant perfusion defect read by an experienced nuclear physician in agreement with a summed stress score 1.1 for the exercise test and > 1.15 for the dipyridamole stress test). A normal gated functional study was described as a global LVEF ≥ 50% with a summed motion score (SMS) and a summed thickening score (STS) of zero [19, 20]. Patients with BMI > 35, complete or incomplete left or right bundle branch block, implanted permanent pacemakers and all the patients with different kinds of cardiac arrhythmias such as atrial fibrillation, atrial f
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