- 作者：Mark A. Trimble ; Salvador Borges-Neto ; Emily F. Honeycutt ; Linda K. Shaw ; Robert Pagnanelli ; Ji Chen ; Ami E. Isk ; rian ; Ernest V. Garcia ; Eric J. Velazquez
- 关键词：Mechanical dyssynchrony ; single photon emission computed tomography imaging ; left ventricular dysfunction ; cardiac resynchronization therapy ; heart failure
- 刊名：Journal of Nuclear Cardiology
- 出版年：2008
- 出版时间：September-October 2008
- 年：2008
- 卷：15
- 期：5
- 页码：663-670
- 全文大小：874 K
Background
Using phase analysis of gated single photon emission computed tomography (SPECT) imaging, we examined the relation between myocardial perfusion, degree of electrical dyssynchrony, and degree of SPECT-derived mechanical dyssynchrony in patients with left ventricular (LV) dysfunction.Methods and Results
We retrospectively examined 125 patients with LV dysfunction and ejection fraction of 35 % or lower. Fourier analysis converts regional myocardial counts into a continuous thickening function, allowing resolution of phase of onset of myocardial thickening. The SD of LV phase distribution (phase SD) and histogram bandwidth describe LV phase dispersion as a measure of dyssynchrony. Heart failure (HF) patients with perfusion abnormalities have higher degrees of dyssynchrony measured by median phase SD (45.5° vs 27.7°, P < .0001) and bandwidth (117.0° vs 73.0°, P = .0006). HF patients with prolonged QRS durations have higher degrees of dyssynchrony measured by median phase SD (54.1° vs 34.7°, P < .0001) and bandwidth (136.5° vs 99.0°, P = .0005). Mild to moderate correlations exist between QRS duration and phase analysis indices of phase SD (r = 0.50) and bandwidth (r = 0.40). Mechanical dyssynchrony (phase SD >43°) was 43.2 % .
Conclusions
HF patients with perfusion abnormalities or prolonged QRS durations have higher degrees of mechanical dyssynchrony. Gated SPECT myocardial perfusion imaging can quantify myocardial function, perfusion, and dyssynchrony and may help in evaluating patients for cardiac resynchronization therapy.