J Nucl Med. 2007; 48 (Supplement 2):234P
Cardiovascular: Clinical Science
Clinical Science Posters |
Phase analysis of gated myocardial perfusion SPECT: A new method to evaluate left ventricular dyssynchrony
Simone Brandao1,
Ji Chen2,
Maria Clementina Giorgi1,
Rubens Abe1,
Silvana Nishioka1,
Martino Martinelli1,
Ernest Garcia2 and
José Claudio Meneghetti1
1 Medicine Nuclear, Heart Institute–University of São Paulo Medical School, Sao Paulo, Brazil; ;
2 Radiology, Emory University, Atlanta, Georgia
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Objectives: Phase Analysis(PA) has been developed to quantify left ventricular(LV) dyssynchrony by calculating the phase of LV myocardial wall thickening from gated myocardial perfusion single-photon emission computed tomography(SPECT). The purpose of this study is to assess whether LV dyssynchrony measured by PA describes the degree of heart failure(HF) and whether it changes concordantly with clinical improvement of NYHA functional class(FC) post cardiac resynchronization therapy(CRT). Methods: Twenty one patients(59±13 y/o, QRS
120 ms, mean LVEF 22%±4%) with dilated cardiomyopathy, HF and FC class III or IV were included. These patients underwent Tc-99m sestamibi rest/stress gated SPECT pre and post CRT. Three months post CRT they were divided into two groups: responders, FC I or II(mild HF) and non-responders, FC III or IV(severe HF). Phase standard deviation(PSD) and phase histogram bandwidth(PHB) given by PA were calculated to quantify LV dyssynchrony. Results: Three months post CRT, 16 patients(76%) were responders and 5 patients(24%) were non-responders. The pre- and post-CRT PA results are listed in the table below. The unpaired t-test between severe and mild HF showed significant differences in both PSD(p=0.0305) and PHB(p=0.0062). The paired t-test between pre-CRT and post-CRT dyssynchrony showed significant differences(PSD: p=0.0643, PHB: p=0.0303) for responders but insignificant differences(PSD: p=0.1715, PHB: p=0.6974) for non-responders. However, the unpaired t-test of pre-CRT dyssynchrony between responders and non-responders did not reach significance(PSD: p=0.2952, PHB: p=0.3429). Conclusions: LV dyssynchrony quantified by PA can differentiate severe HF from mild HF and can be useful for assessment of the effect of CRT. The next step is to include more patients and to investigate whether it can predict the responses to CRT.
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Phase Analysis Pre- and Post- Cardiac Resynchronization Therapy
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