The role of nuclear medicine in assessments of cardiac dyssynchrony
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Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
Received Aug 29, 2017; accepted Aug 29, 2017 doi:10.1007/s12350-017-1072-z
Radionuclide imaging has an advantage for quantitative analyses of the tracer concentration and its temporal changes. Myocardial perfusion and function have been adapted for synchrony analyses. Extracted parameters have been demonstrated to measure ventricular synchrony and even to predict CRT outcomes. ERNA has the advantages of higher temporal resolution, greater reproducibility, and the volumetric analysis of both ventricles that can be applied for analyses of intraventricular synchrony and interventricular synchrony. Several software packages such as Quantitative Gated SPECT, the Emory Cardiac Toolbox, cardioREPO, and Heart Function View are available to assess the LV dyssynchrony parameters from GSPECT. A count-based method is applied to extract the amplitude and phase from each of the reconstructed GSPECT short-axis datasets throughout the cardiac cycle and then subjected to a Fourier analysis, the results of which are displayed on a polar map and histogram. Some of the parameters such as the bandwidth (expressed as the 95% width of the phase histogram) and the standard deviation of the phase are obtained by the phase histogram to assess the intraventricular synchrony. This review paper focuses on the application of the LV dyssynchrony parameters estimated by cardiac SPECT in patients with a heart disease. (J Nucl Cardiol 2017) Key Words: Nuclear medicine Æ radionuclide imaging Æ cardiac dyssynchrony Æ cardiac imaging technology Abbreviations CMR Cardiac magnetic resonance CRT Cardiac resynchronization therapy ERNA Equilibrium radionuclide angiography
INTRODUCTION Several conduction abnormalities are commonly seen in patients with heart failure. These abnormalities produce suboptimal ventricular filling, a reduction of Electronic supplementary material The online version of this article (doi:10.1007/s12350-017-1072-z) contains supplementary material, which is available to authorized users. The authors of this article have provided a PowerPoint file, available for download at SpringerLink, which summarizes the contents of the paper and is free for re-use at meetings and presentations. Search for the article DOI on SpringerLink.com.
GSP ECT LV
Gated perfusion single-photon emission computed tomography Left ventricular
ventricular contractility, a prolonged duration of mitral regurgitation, and paradoxical septal wall motion.1,2 These mechanical manifestations of altered ventricular contraction, termed ‘‘ventricular dyssynchrony,’’ may also increase mortality in heart failure patients. Cardiac Reprint requests: Masanao Naya, MD, PhD, Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-ku, Sappor
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