Impact of Hypertension on the Phase Analysis Parameters of Gated Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging

Authors

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

Abstract

Background: We sought to evaluate the association between hypertension (HTN) and left ventricular (LV) mechanical synchrony parameters derived via the phase analysis of gated single-photon emission computed tomography (GSPECT) myocardial perfusion imaging (MPI). Methods: Ninety-nine patients with no known coronary heart disease (CHD) who underwent GSPECT MPI and had normal resting and post-stress scan with a recent normal echocardiographic examination and a positive history of HTN were recruited. The gated images were analyzed by Cedar–Sinai’s quantitative GSPECT. The global and regional LV mechanical synchrony indices—including phase histogram bandwidth (PHB), phase standard deviation (PSD), and entropy—were derived and compared with the results of the control group, which had previously been defined with the same protocol for a group of 100 patients with a low likelihood for CHD. Results: Comparisons between the study and control groups revealed that neither global nor regional wall-based indices for PHB, PSD, and entropy were significantly different between the 2 groups (P> 0.05), whether or not HTN was accompanied by comorbid diabetes. Congruent with the control group, a significant difference was detected between the global LV phase parameters of the 2 genders (P<0.05). Conclusions: HTN does not intrinsically have a significant impact on the mechanical synchrony indices of GSPECT MPI.

Keywords


  1. Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97(18):1837-47.
  2. Khot UN, Khot MB, Bajzer CT, Sapp SK, Ohman EM, Brener SJ, et al. Prevalence of conventional risk factors in patients with coronary heart disease. Jama. 2003;290(7):898-904.
  3. Santos M, Shah AM. Alterations in cardiac structure and function in hypertension. Current hypertension reports. 2014;16(5):428.
  4. Noh J, Kim HC, Shin A, Yeom H, Jang S-Y, Lee JH, et al. Prevalence of Comorbidity among People with Hypertension: The Korea National Health and Nutrition Examination Survey 2007-2013. Korean circulation journal. 2016;46(5):672-80.
  5. Devereux RB, Roman MJ, Paranicas M, O’grady MJ, Lee ET, Welty TK, et al. Impact of diabetes on cardiac structure and function: the strong heart study. Circulation. 2000;101(19):2271-6.
  6. Chen J, Garcia EV, Bax JJ, Iskandrian AE, Borges-Neto S, Soman P. SPECT myocardial perfusion imaging for the assessment of left ventricular mechanical dyssynchrony. Journal of Nuclear Cardiology. 2011;18(4):685-94.
  7. Van Kriekinge SD, Nishina H, Ohba M, Berman DS, Germano G. Automatic global and regional phase analysis gated myocardial perfusion SPECT imaging: application to the characterization of ventricular contraction in patients with left bundle branch block. The Journal of Nuclear Medicine. 2008;49(11):1790.
  8. AlJaroudi W, Jaber WA, Cerqueira MD. Effect of tracer dose on left ventricular mechanical dyssynchrony indices by phase analysis of gated single photon emission computed tomography myocardial perfusion imaging. Journal of Nuclear Cardiology. 2012;19(1):63-72.
  9. AlJaroudi W, Koneru J, Heo J, Iskandrian AE. Impact of ischemia on left ventricular dyssynchrony by phase analysis of gated single photon emission computed tomography myocardial perfusion imaging. Journal of Nuclear Cardiology. 2011;18(1):36-42.
  10. Trimble MA, Velazquez EJ, Adams GL, Honeycutt EF, Pagnanelli RA, Barnhart HX, et al. Repeatability and reproducibility of phase analysis of gated single-photon emission computed tomography myocardial perfusion imaging used to quantify cardiac dyssynchrony. Nuclear medicine communications. 2008;29(4):374.
  11. Lin X, Xu H, Zhao X, Folks RD, Garcia EV, Soman P, et al. Repeatability of left ventricular dyssynchrony and function parameters in serial gated myocardial perfusion SPECT studies. Journal of nuclear cardiology. 2010;17(5):811-6.
  12. Yaghoobi N, Malek H. The age of reason for gated SPECT MPI to deal with cardiac dyssynchrony. Research in cardiovascular medicine. 2015;4(1).
  13. Al-Jaroudi W, Iqbal F, Heo J, Iskandrian AE. Relation between heart rate and left ventricular mechanical dyssynchrony in patients with end-stage renal disease. American Journal of Cardiology. 2011;107(8):1235-40.
  14. Li D, Zhou Y, Feng J, Yuan D, Cao K, Garcia EV, et al. Impact of image reconstruction on phase analysis of ECG-gated myocardial perfusion SPECT studies. Nuclear medicine communications. 2009;30(9):700.
  15. Misaka T, Hosono M, Kudo T, Ito T, Syomura T, Uemura M, et al. Influence of acquisition orbit on phase analysis of gated single photon emission computed tomography myocardial perfusion imaging for assessment of left ventricular mechanical dyssynchrony. Annals of nuclear medicine. 2017;31(3):235-44.
  16. Vasan RS, Larson MG, Benjamin EJ, Evans JC, Reiss CK, Levy D. Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction: prevalence and mortality in a population-based cohort. Journal of the American College of Cardiology. 1999;33(7):1948-55.
  17. 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.
  18. Henzlova MJ, Duvall WL, Einstein AJ, Travin MI, Verberne HJ. ASNC imaging guidelines for SPECT nuclear cardiology procedures: Stress, protocols, and tracers. Journal of Nuclear Cardiology. 2016;23(3):606-39.
  19. Malek H, Ghaedian T, Yaghoobi N, Rastgou F, Bitarafan-Rajabi A, Firoozabadi H. Focal breast uptake of 99mTc-sestamibi in a man with spindle cell lipoma. Journal of Nuclear Cardiology. 2012;19(3):618-20.
  20. Malek H, Yaghoobi N, Hedayati R. Artifacts in Quantitative analysis of myocardial perfusion SPECT, using Cedars-Sinai QPS Software. Journal of Nuclear Cardiology. 2017;24(2):534-42.
  21. Malek H, Hedayati R, Yaghoobi N, Bitarafan-Rajabi A, Firoozabadi SH, Rastgou F. The effect of milk, water and lemon juice on various subdiaphragmatic activity-related artifacts in myocardial perfusion imaging. Research in cardiovascular medicine. 2015;4(4).
  22. Romero-Farina G, Aguadé-Bruix S, Candell-Riera J, Pizzi MN, García-Dorado D. Cut-off values of myocardial perfusion gated-SPECT phase analysis parameters of normal subjects, and conduction and mechanical cardiac diseases. Journal of Nuclear Cardiology. 2015;22(6):1247-58.
  23. Singh H, Patel CD, Sharma P, Naik N, Singh S, Narang R. Does perfusion pattern influence stress-induced changes in left ventricular mechanical dyssynchrony on thallium-201-gated SPECT myocardial perfusion imaging? Journal of Nuclear Cardiology. 2015;22(1):36-43.
  24. Pazhenkottil AP, Buechel RR, Herzog BA, Nkoulou RN, Valenta I, Fehlmann U, et al. Ultrafast assessment of left ventricular dyssynchrony nuclear myocardial perfusion imaging on a new high-speed gamma camera. European journal of nuclear medicine and molecular imaging. 2010;37(11):2086-92.
  25. McLaughlin MG, Danias PG. Transient ischemic dilation: a powerful diagnostic and prognostic finding of stress myocardial perfusion imaging. Journal of nuclear cardiology. 2002;9(6):663-7.
  26. Emmett L, Van Gaal WJ, Magee M, Bass S, Ali O, Freedman SB, et al. Prospective evaluation of the impact of diabetes and left ventricular hypertrophy on the relationship between ischemia and transient ischemic dilation of the left ventricle on single-day adenosine Tc-99m myocardial perfusion imaging. Journal of nuclear cardiology. 2008;15(5):638-43.
  27. Hämäläinen H, Hedman M, Laitinen T, Hedman A, Kivelä A, Laitinen T. Reference values for left ventricular systolic synchrony according to phase analysis of ECG‐gated myocardial perfusion SPECT. Clinical physiology and functional imaging. 2018;38(1):38-45.
  28. Samad Z, Atchley AE, Trimble MA, Sun J-L, Shaw LK, Pagnanelli R, et al. Prevalence and predictors of mechanical dyssynchrony as defined by phase analysis in patients with left ventricular dysfunction undergoing gated SPECT myocardial perfusion imaging. Journal of Nuclear Cardiology. 2011;18(1):24-30.