Correlation Between Ventricular Perfusion Ischemia and Left Ventricular Dyssynchrony in Phase Analysis by Gated SPECT MPI

Document Type : Original Article

Authors

1 Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

2 Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

3 Rasule Akram General Hospital, Iran University of Medical Sciences, Tehran, IR Iran.

Abstract

Background: The gated single-photon emission computed tomography (Gated SPECT), myocardial perfusion imaging (MPI) is one of the most accurate methods to evaluate the extent of myocardial ischemia. The present study aimed to assess the correlation between the severity of ischemia and left ventricular dyssynchrony in phase analysis with GATED SPECT MPI by comparing the indices of perfusion, function, and phase analysis in stress and rest phases.
 
Methods: This cross-sectional study was performed on patients referred for Gated SPECT MPI. Fifty-six patients with ischemic heart disease based on Gated SPECT MPI and invasive coronary angiography were included. Parameters regarding myocardial perfusion and function in stress and rest conditions and coronary vessel parameters were assessed. Phase analysis indices, including phase standard deviation (PSD), phase histogram bandwidth (PHB), and entropy, based on Gated SPECT MPI (with the QGS software) were also evaluated
 
Results: Phase parameters, including PSD, PHB, and entropy, showed a good correlation with the severity of ischemia in stress conditions (P<0.05).
 
Conclusions: Scintigraphic indices of ischemia severity were highly correlated with phase analysis indices by Gated SPECT MPI. Therefore, an evaluation of these indices may accurately estimate systolic ventricular dyssynchrony, predict relative poor outcomes of cardiac ischemic events, and determine priorities for interventional cardiologists. (Iranian Heart Journal 2022; 23(1): 184-191)

Keywords


  1. Psota M, Bandosz P, Goncalvesova E, Avdičová M, Pšenková MB, Studenčan M, et al. Explaining the decline in coronary heart disease mortality rates in the Slovak Republic between 1993-2008. PloS one. 2018; 13(1).
  2. Rahimi K, Lam CS, Steinhubl S. Cardiovascular disease and multimorbidity: A call for interdisciplinary research and personalized cardiovascular care. PLoS medicine. 2018; 15(3).
  3. Liu Y, Jiang Y, Yang X, Geng B, Liu Y, Shang X, et al. Limited prognostic value of myocardial viability assessment in patients with coronary artery diseases and severe left ventricular dysfunction. Journal of thoracic disease. 2018; 10(4):2249.
  4. Claridge S, Briceno N, Chen Z, De Silva K, Modi B, Jackson T, et al. Changes in contractility determine coronary haemodynamics in dyssynchronous left ventricular heart failure, not vice versa. IJC heart & vasculature. 2018; 19:8-13.
  5. Gimelli A, Liga R, Genovesi D, Giorgetti A, Kusch A, Marzullo P. Association between left ventricular regional sympathetic denervation and mechanical dyssynchrony in phase analysis: a cardiac CZT study. European journal of nuclear medicine and molecular imaging. 2014; 41(5):946-55.
  6. Chen J, Garcia E, Henneman M, Bax J, Boogers M, Trimble M, et al. Measuring left ventricular mechanical dyssynchrony from ECG-gated SPECT myocardial perfusion imaging. Minerva cardioangiologica. 2008; 56(2):227-35.
  7. Chen J, Garcia EV, Lerakis S, Henneman MM, Bax JJ, Trimble MA, et al. Left Ventricular Mechanical Dyssynchrony as Assessed by Phase Analysis of ECG‐Gated SPECT Myocardial Perfusion Imaging. Echocardiography. 2008; 25(10):1186-94.
  8. Keida T, Ohira H, Fujita M, Chinen T, Nakamura K, Kato T, et al. Quantitative assessment of dyssynchrony using ECG-gated SPECT myocardial perfusion imaging prior to and following cardiac resynchronization therapy. Circulation Journal. 2009:0901070225-.
  9. Henneman MM, Chen J, Ypenburg C, Dibbets P, Bleeker GB, Boersma E, et al. Phase analysis of gated myocardial perfusion single-photon emission computed tomography compared with tissue Doppler imaging for the assessment of left ventricular dyssynchrony. Journal of the American College of Cardiology. 2007; 49(16):1708-14.
  10. Marsan NA, Henneman MM, Chen J, Ypenburg C, Dibbets P, Ghio S, et al. Left ventricular dyssynchrony assessed by two three-dimensional imaging modalities: phase analysis of gated myocardial perfusion SPECT and tri-plane tissue Doppler imaging. European journal of nuclear medicine and molecular imaging. 2008; 35(1):166-73.
  11. Hekmat S, Rastgoo F, Omrani G, Yaghoobi N, Baghaie R, Firoozabadi H, et al. Comparison of the myocardial perfusion and wall motion results by ECG-Gated 99mTc-MIBI SPECT, before and after CABG for evaluation of myocardial viability [Persian]. Iranian Journal of Nuclear Medicine. 2003; 11(1):29-32.
  12. Malek H, Rayegan F, Firoozabadi H, Rastgoo F, Haghjoo M, Bakhshandeh H, et al. Determination of normal ranges of regional and global phase parameters using gated myocardial perfusion imaging with Cedars-Sinai’s QGS software. Iranian Journal of Nuclear Medicine. 2018; 26(1):16-21.
  13. Cho S-G, Jabin Z, Park KS, Kim J, Kang S-R, Kwon SY, et al. Clinical values of left ventricular mechanical dyssynchrony assessment by gated myocardial perfusion SPECT in patients with acute myocardial infarction and multivessel disease. European journal of nuclear medicine and molecular imaging. 2017; 44(2):259-66.
  14. Goldberg AS, Alraies MC, Cerqueira MD, Jaber WA, AlJaroudi WA. Prognostic value of left ventricular mechanical dyssynchrony by phase analysis in patients with non-ischemic cardiomyopathy with ejection fraction 35-50% and QRS< 150 ms. Journal of Nuclear Cardiology. 2014; 21(1):57-66.
  15. Uebleis C, Hellweger S, Laubender RP, Becker A, Sohn H-Y, Lehner S, et al. Left ventricular dyssynchrony assessed by gated SPECT phase analysis is an independent predictor of death in patients with advanced coronary artery disease and reduced left ventricular function not undergoing cardiac resynchronization therapy. European journal of nuclear medicine and molecular imaging. 2012; 39(10):1561-9.
  16. Trimble MA, Borges-Neto S, Honeycutt EF, Shaw LK, Pagnanelli R, Chen J, et al. Evaluation of mechanical dyssynchrony and myocardial perfusion using phase analysis of gated SPECT imaging in patients with left ventricular dysfunction. Journal of nuclear cardiology. 2008; 15(5):663-70.
  17. Garcia EV, Slomka P, Moody JB, Germano G, Ficaro EP. Quantitative Clinical Nuclear Cardiology, Part 1: Established Applications. Journal of Nuclear Medicine. 2019; 60(11):1507-16.
  18. Malek H, Hedayati R, Yaghoobi N, Behnia M, Rastgou F, Bitarafan Rajabi A, et al. The relationship between retinopathy in diabetes mellitus type 2 and severity and extent of myocardial ischemia in myocardial perfusion imaging. Iranian Heart Journal. 2013; 13(4):6-14.
  19. Bitarafan-Rajabi A, Rastgou F, Hosseini S, Firoozabadi H, Malek H, Amouzadeh H, et al. Assessment of myocardial viability in patients with left ventricular dysfunction: Correlation between CT-based attenuation correction and uncorrected quantification analysis in thallium201 (201Tl) rest-redistribution SPECT study. Iranian Heart Journal. 2013:15-20.
  20. Rastgou F, Shojaeifard M, Amin A, Ghaedian T, Firoozabadi H, Malek H, et al. Assessment of left ventricular mechanical dyssynchrony by phase analysis of gated-SPECT myocardial perfusion imaging and tissue Doppler imaging: comparison between QGS and ECTb software packages. Journal of Nuclear Cardiology. 2014; 21(6):1062-71.