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Shimizu M, Kimura S, Fujii H, Suzuki M, Nishizaki M, Sasano T. Machine Learning for Multi-Vessel Coronary Artery Disease Prediction on Electrocardiogram Gated Single-Photon Emission Computed Tomography. ANNALS OF NUCLEAR CARDIOLOGY 2023; 9:11-18. [PMID: 38058573 PMCID: PMC10696148 DOI: 10.17996/anc.22-00155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/08/2022] [Accepted: 08/15/2022] [Indexed: 12/08/2023]
Abstract
Background: Single-photon emission computed tomography (SPECT) encounters difficulties in diagnosing severe multi-vessel coronary artery disease (svMVD) because of balanced ischemia. We estimated the predictive value of electrocardiogram-gated SPECT for svMVD and improved it using machine learning (ML). Methods and results: We enrolled consecutive 335 patients (median age, 74 years; 255 men) who underwent adenosine stress-gated SPECT (99mTechnesium) and coronary angiography. svMVD was defined as three-vessel disease or left main tract stenosis. Predictive models were constructed using statistical and ML methods. Eighteen cases (5%) showed svMVD, and diabetes, summed stress score (SSS), and the max difference among segmental time of stroke volume per cardiac cycle (MDSV: a parameter of left ventricular [LV] end-systolic dyssynchrony) on adenosine stress were independent significant predictors. The area under the receiver operating characteristic curve (AUC) of SSS and MDSV on stress were 0.759 and 0.763, respectively. Conversely, the extra trees classifier and light gradient boosting machine had improved AUC values of 0.826 and 0.870, respectively, and the MDSV on stress and diabetes showed high feature values in the ML models. Conclusion: ML on SPECT helped to improve the diagnostic performance of svMVD and diabetes, and the parameters of LV dyssynchrony played essential roles in the ML predictive models.
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Affiliation(s)
- Masato Shimizu
- Department of Cardiology, Yokohama Minami Kyosai Hospital, Yokohama, Japan
| | - Shigeki Kimura
- Department of Cardiology, Yokohama Minami Kyosai Hospital, Yokohama, Japan
| | - Hiroyuki Fujii
- Department of Cardiology, Yokohama Minami Kyosai Hospital, Yokohama, Japan
| | - Makoto Suzuki
- Department of Cardiology, Yokohama Minami Kyosai Hospital, Yokohama, Japan
| | | | - Tetsuo Sasano
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
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2
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Jin W, Yu C, Wang L, Ma Y, He D, Zhu T. Abnormal inter-ventricular diastolic mechanical delay in patients with ST-segment elevation myocardial infarction. BMC Cardiovasc Disord 2023; 23:494. [PMID: 37803312 PMCID: PMC10559586 DOI: 10.1186/s12872-023-03531-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 09/24/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND This study aimed to investigate the ventricular mechanical relaxation pattern and its clinical influence in patients with ST-segment elevation myocardial infarction (STEMI). METHODS Echocardiography was performed to measure mitral and tricuspid diastolic opening times. Left ventricular diastolic mechanical delay (LVMDd) was defined as diastolic filling of the right ventricle earlier than that of the left ventricle, and right ventricular diastolic mechanical delay (RVMDd) was defined as the right ventricular diastolic filling later than left ventricular filling. RESULTS Among 152 patients with STEMI, 100 (65.8%) had LVMDd, and 47 (30.9%) had RVMDd. In-hospital complications were significantly increased in patients with RVMDd (61.6% vs. 41.0%, P = 0.017). Those with RVMDd exhibited significantly lower left ventricular global longitudinal strain (11.7 ± 4.1% vs. 13.2 ± 4.0%, P = 0.035), global work index (913.8 ± 365.9 vs. 1098.9 ± 358.8 mmHg%, P = 0.005) and global constructive work (1218.6 ± 392.8 vs. 1393.7 ± 432.7 mmHg%, P = 0.021). Mitral deceleration time significantly decreased (127.4 ± 33.5 vs. 145.6 ± 41.7 ms, P = 0.012), and the ratio of early mitral inflow to early mitral annular velocity (E/E') significantly increased [13.0(11.0-20.0) vs. 11.9(9.3-14.3), P = 0.006] in the RVMDd group. Logistic regression analysis showed that age (odds ratio [OR]:0.920; P = 0.001), brain natriuretic peptide level (OR: 1.1002; P = 0.036) and mitral E/E' (OR: 1.187; P = 0.003) were independently associated with RVMDd. CONCLUSIONS Delayed right ventricular filling is related to more severe left ventricular systolic and diastolic dysfunction in STEMI patients. More attention should be paid to patients with RVMDd to prevent adverse events during hospitalization.
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Affiliation(s)
- Wenying Jin
- Department of Cardiology, Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction, Center for Cardiovascular Translational Research, Peking University People's Hospital, Beijing, China
| | - Chao Yu
- Department of Cardiology, Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction, Center for Cardiovascular Translational Research, Peking University People's Hospital, Beijing, China
| | - Lan Wang
- Department of Cardiology, Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction, Center for Cardiovascular Translational Research, Peking University People's Hospital, Beijing, China
| | - Yuliang Ma
- Department of Cardiology, Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction, Center for Cardiovascular Translational Research, Peking University People's Hospital, Beijing, China
| | - Dan He
- Department of Cardiology, Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction, Center for Cardiovascular Translational Research, Peking University People's Hospital, Beijing, China
| | - Tiangang Zhu
- Department of Cardiology, Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction, Center for Cardiovascular Translational Research, Peking University People's Hospital, Beijing, China.
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Shipulin VV, Andreev S, Kopeva K, Shipulin VM, Zavadovsky K. The Value of Stress-Gated Blood Pool SPECT in Predicting Early Postoperative Period Complications in Ischemic Cardiomyopathy Patients: Focus on Mechanical Dyssynchrony. J Clin Med 2023; 12:5328. [PMID: 37629370 PMCID: PMC10455889 DOI: 10.3390/jcm12165328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
(1) Objective: The objective of this study was to assess the prognostic value of stress-gated blood pool SPECT (GBPS) estimates in patients with ischemic cardiomyopathy (ICM) in the early postoperative period. (2) Methods: A total of 57 patients (age 59.7 ± 6.6, 47 men) with ICM and LV ejection fraction (30 [27.5; 35]%) were enrolled in the study. Before surgical treatment, all patients underwent GBPS (rest-stress, dobutamine doses of 5/10/15 µg/kg/min). Stress-induced changes in left ventricular (LV) ejection fraction, peak ejection rate, volumes, and mechanical dyssynchrony (phase histogram standard deviation, phase entropy (PE), and phase histogram bandwidth) were estimated. Two-dimensional transthoracic echocardiography was performed baseline. Serum levels of NT-proBNP were analyzed with enzyme-linked immunoassay. (3) Results: After surgical treatment, patients were divided into two groups, one, with death, the need for an intra-aortic balloon pump (IABP) or/and inotropic support with a stay in the intensive care unit for more than two days and two, without complications in the early postoperative period (EPOP). Complicated EPOP (CEPOP) was observed in 17 (30%) patients (death-2, IABP-4, extra inotropic support in intensive care unit-11), and 40 patients had no complications (NCEPOP). GBPS showed differences in LV EDV (mL) (321 [268; 358] vs. 268 [242; 313], p = 0.02), LV ESV (mL) (242 [201; 282] vs. 196 [170; 230], p = 0.005), and stress-induced changes in PE (1 (-2; 3) vs. -2 (-4; 0), p = 0.02). Aortic cross-clamp time and stress-induced changes in PE between rest and dobutamine dose of 10 µg/kg/min were the only independent predictors of CEPOP. An increase in LV entropy ≥ 1 on the dobutamine dose of 10µg/kg/min in comparison to rest investigation showed AUC = 0.853 (sensitivity = 62%, specificity = 90%, PPV = 71%; NPV = 85%; p < 0.0001). Conclusion: Stress-induced changes in PE obtained during low-dose dobutamine GBPS are associated with a complicated course of the early postoperative period after surgical treatment for ICM.
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Affiliation(s)
- Vladimir V. Shipulin
- Nuclear Department, Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia; (V.V.S.); (K.Z.)
| | - Sergey Andreev
- Surgical Department, Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia; (S.A.); (V.M.S.)
| | - Kristina Kopeva
- Department of Myocardial Pathology, Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia
| | - Vladimir M. Shipulin
- Surgical Department, Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia; (S.A.); (V.M.S.)
| | - Konstantin Zavadovsky
- Nuclear Department, Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia; (V.V.S.); (K.Z.)
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Kuronuma K, Matsumoto N, Van Kriekinge SD, Slomka PJ, Berman DS. Usefulness of phase analysis on ECG gated single photon emission computed tomography myocardial perfusion imaging. J Cardiol 2023; 82:87-92. [PMID: 36858173 DOI: 10.1016/j.jjcc.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/10/2023] [Indexed: 03/02/2023]
Abstract
Electrocardiogram (ECG)-gated single photon emission computed tomography myocardial perfusion imaging (GSPECT-MPI) is widely used for assessing coronary artery disease. Phase analysis on GSPECT-MPI can assess left ventricular mechanical dyssynchrony quantitatively on standard GSPECT-MPI alongside myocardial perfusion and function assessment. It has been shown that phase variables by GSPECT-MPI correlate well with tissue Doppler imaging by echocardiography. Main phase variables quantified by GSPECT-MPI are entropy, bandwidth, and phase standard deviation. Although those variables are automatically obtained from several software packages including Quantitative Gated SPECT and Emory Cardiac Toolbox, the methods for their measurement vary in each package. Several studies have shown that phase analysis has predictive value for response to cardiac resynchronization therapy and prognostic value for future adverse cardiac events beyond standard GSPECT-MPI variables. In this review, we summarize the basics of phase analysis on GSPECT-MPI and usefulness of phase analysis in clinical practice.
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Affiliation(s)
- Keiichiro Kuronuma
- Departments of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Cardiology, Nihon University, Tokyo, Japan.
| | | | - Serge D Van Kriekinge
- Departments of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Piotr J Slomka
- Departments of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Daniel S Berman
- Departments of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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5
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Jalkh K, AlJaroudi W. Left ventricular mechanical dyssnchrony: A potential new marker for 3-vessel CAD. J Nucl Cardiol 2023; 30:1230-1234. [PMID: 36864242 DOI: 10.1007/s12350-023-03232-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 02/10/2023] [Indexed: 03/04/2023]
Affiliation(s)
- Khalil Jalkh
- Division of Cardiovascular Medicine, Augusta University-Medical College of Georgia, Office BB-6520B, Augusta, GA, USA
| | - Wael AlJaroudi
- Division of Cardiovascular Medicine, Augusta University-Medical College of Georgia, Office BB-6520B, Augusta, GA, USA.
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6
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Zhu JY, Wang XC, Huang N, Li XQ, Cheng Y, Wu ZF, Li YY, Wu P, Li L, Wei H, Li SJ, Cao JM. Prognostic value of summed motion score assessed by gated SPECT myocardial perfusion imaging in patients with dilated cardiomyopathy. Front Cardiovasc Med 2023; 10:1144333. [PMID: 37008320 PMCID: PMC10050370 DOI: 10.3389/fcvm.2023.1144333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 02/28/2023] [Indexed: 03/17/2023] Open
Abstract
BackgroundThe prognosis of patients with dilated cardiomyopathy (DCM) is poor and new indicators are urgently needed to predict lethal cardiac events. This study aimed to investigate the value of summed motion score (SMS) in predicting cardiac death of DCM patients using gated single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI).Methods and resultsEighty-one patients with DCM who underwent 99mTc-MIBI gated SPECT MPI were retrospectively enrolled and were divided into cardiac death and survivor groups. The functional parameters of left ventricle including SMS were measured using quantitative gated SPECT software. During the follow-up period of 44 (25, 54) months, 14 (17.28%) cardiac deaths were observed. Compared with the survivor group, SMS was significantly higher in the cardiac death group. Multivariate cox regression analysis showed that SMS was an independent predictor for cardiac death (HR 1.34, 95% CI 1.02–1.77, P = 0.034). SMS also provided incremental prognostic value over other variables in the multivariate model as determined by likelihood ratio global chi-squared test. In the Kaplan-Meier survival analysis, the event-free survival rate was significantly lower in the high-SMS (HSMS) group than the low-SMS (LSMS) (log-rank P < 0.001). Furthermore, the area under curve (AUC) of SMS was larger than that of LVEF at the 12th month of follow-up (0.85 vs. 0.80, P = 0.045).ConclusionSMS is an independent predictor of cardiac death in DCM patients and provides incremental prognostic value. SMS might have higher predictive value than LVEF for early cardiac death.
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Affiliation(s)
- Jun-Yan Zhu
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, China
- Department of Physiology, Shanxi Medical University, Taiyuan, China
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Xin-Chao Wang
- School of Public Health, Shanxi Medical University, Taiyuan, China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, China
| | - Nan Huang
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiao-Qian Li
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yan Cheng
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, China
| | - Zhi-Fang Wu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, China
| | - Yuan-Yuan Li
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, China
- Department of Physiology, Shanxi Medical University, Taiyuan, China
- Department of Critical Care Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Ping Wu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, China
| | - Li Li
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, China
| | - Hua Wei
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Si-Jin Li
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, China
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Correspondence: Si-Jin Li ; Ji-Min Cao
| | - Ji-Min Cao
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, China
- Department of Physiology, Shanxi Medical University, Taiyuan, China
- Correspondence: Si-Jin Li ; Ji-Min Cao
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7
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Shipulin VV, Andreev SL, Pryakhin AS, Mochula AV, Maltseva AN, Sazonova SI, Shipulin VM, Massalha S, Zavadovsky KV. Low-dose dobutamine stress gated blood pool SPECT assessment of left ventricular contractile reserve in ischemic cardiomyopathy: a feasibility study. Eur J Nucl Med Mol Imaging 2022; 49:2219-2231. [PMID: 35150293 DOI: 10.1007/s00259-022-05714-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 01/28/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE The purpose of the present study was to evaluate the feasibility of gated blood pool single-photon emission computed tomography (GBPS) with low-dose dobutamine (LDD) stress test, performed on a single-photon emission computed tomography (SPECT) camera equipped with cadmium-zinc-telluride (CZT) solid-state detectors, in assessing of left ventricle (LV) contractile reserve in patients with ischemic cardiomyopathy (ICM). METHODS A total of 52 patients (age 59 ± 7.2 years, 47 men and 5 women) with ICM and a control group of 10 patients without obstructive coronary artery lesion underwent GBPS and transthoracic echocardiography (TTE) at rest and during LDD stress test (5, 10, 15 µg/kg/min). The duration of each GBPS step was 5 min. Stress-induced changes in LV ejection fraction (ΔLVEF), peak ejection rate, LV volumes, and mechanical dyssynchrony (phase histogram standard deviation, phase histogram bandwidth and entropy) obtained with GBPS were estimated. RESULTS All GBPS indices except end-diastolic volume showed significant dynamics during stress test in both groups. The majority of parameters in ICM patients showed significant changes at a dobutamine dose of 10 µg/kg/min as compared to the rest study. Seventeen percent of ICM patients, but none from the control group, showed a decrease in LVEF during stress, accompanied by a significant increase in entropy. The intra- and inter-observer reproducibility was excellent for both rest and stress studies. There was a moderate correlation (r = 0.5, p = 0.01) between GBPS and TTE, with a mean difference value of - 1.7 (95% confidence interval - 9.8; 6.4; p = 0.06) in ΔLVEF. CONCLUSION Low-dose dobutamine stress GBPS performed with high-efficiency CZT-SPECT cameras can be performed for evaluating stress-induced changes in LV contractility and dyssynchrony with lower acquisition time. A dobutamine dose of 10 µg/kg/min can potentially suffice to detect stress-induced changes in patients with ICM during GBPS. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT04508608 (August 7, 2020).
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Affiliation(s)
- Vladimir V Shipulin
- Nuclear Medicine Department, Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Russian Federation, Kievskaya str. 111a, Tomsk, 634012, Russia
| | - Sergey L Andreev
- Cardiovascular Surgery Department, Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Russian Federation, Kievskaya str. 111a, Tomsk, 634012, Russia
| | - Andrew S Pryakhin
- Cardiovascular Surgery Department, Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Russian Federation, Kievskaya str. 111a, Tomsk, 634012, Russia
| | - Andrew V Mochula
- Nuclear Medicine Department, Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Russian Federation, Kievskaya str. 111a, Tomsk, 634012, Russia
| | - Alina N Maltseva
- Nuclear Medicine Department, Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Russian Federation, Kievskaya str. 111a, Tomsk, 634012, Russia
| | - Svetlana I Sazonova
- Nuclear Medicine Department, Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Russian Federation, Kievskaya str. 111a, Tomsk, 634012, Russia
| | - Vladimir M Shipulin
- Administrative Department, Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Russian Federation, Kievskaya str. 111a, Tomsk, 634012, Russia
| | - Samia Massalha
- Department of Cardiology, Rambam HealthCare Campus, Haifa, Israel.,Department of Nuclear Medicine, Rambam HealthCare Campus, Haifa, Israel
| | - Konstantin V Zavadovsky
- Nuclear Medicine Department, Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Russian Federation, Kievskaya str. 111a, Tomsk, 634012, Russia.
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8
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Zhu T, Lei M, Wang Z, Zhang R, Zhang Y, Jin W, Yu C, Huang CLH, Liu D, Zheng W, Liu Y, Quan X, Kong L, Liang S, Zhang X. A Comparative Study of Systolic and Diastolic Mechanical Synchrony in Canine, Primate, and Healthy and Failing Human Hearts. Front Cardiovasc Med 2021; 8:750067. [PMID: 34778406 PMCID: PMC8581184 DOI: 10.3389/fcvm.2021.750067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/28/2021] [Indexed: 11/13/2022] Open
Abstract
Aim: Mechanical dyssynchrony (MD) is associated with heart failure (HF) and may be prognostically important in cardiac resynchronization therapy (CRT). Yet, little is known about its patterns in healthy or diseased hearts. We here investigate and compare systolic and diastolic MD in both right (RV) and left ventricles (LV) of canine, primate and healthy and failing human hearts. Methods and Results: RV and LV mechanical function were examined by pulse-wave Doppler in 15 beagle dogs, 59 rhesus monkeys, 100 healthy human subjects and 39 heart failure (HF) patients. This measured RV and LV pre-ejection periods (RVPEP and LVPEP) and diastolic opening times (Q-TVE and Q-MVE). The occurrence of right (RVMDs) and left ventricular systolic mechanical delay (LVMDs) was assessed by comparing RVPEP and LVPEP values. That of right (RVMDd) and left ventricular diastolic mechanical delay (LVMDd) was assessed from the corresponding diastolic opening times (Q-TVE and Q-MVE). These situations were quantified by values of interventricular systolic (IVMDs) and diastolic mechanical delays (IVMDd), represented as positive if the relevant RV mechanical events preceded those in the LV. Healthy hearts in all species examined showed greater LV than RV delay times and therefore positive IVMDs and IVMDd. In contrast a greater proportion of the HF patients showed both markedly increased IVMDs and negative IVMDd, with diastolic mechanical asynchrony negatively correlated with LVEF. Conclusion: The present IVMDs and IVMDd findings have potential clinical implications particularly for personalized setting of parameter values in CRT in individual patients to achieve effective treatment of HF.
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Affiliation(s)
- Tiangang Zhu
- Department of Cardiology, Peking University People's Hospital, Beijing, China
| | - Ming Lei
- Medical Sciences Division, Department of Pharmacology, University of Oxford, Oxford, United Kingdom.,Key Laboratory of Medical Electrophysiology of Ministry of Education, Institute of Cardiovascular Research, Southwest Medical University, Luzhou, China
| | - Zhilong Wang
- Department of Cardiology, Peking University People's Hospital, Beijing, China.,Department of Cardiology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Rongli Zhang
- Institute of Molecular Medicine, College of Future Technology, Peking University, Beijing, China.,Case Cardiovascular Research Institute, Institute for Molecular Transformative Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Yan Zhang
- Institute of Molecular Medicine, College of Future Technology, Peking University, Beijing, China.,Beijing Key Laboratory of Cardiometabolic Molecular Medicine, Peking University, Beijing, China
| | - Wenying Jin
- Department of Cardiology, Peking University People's Hospital, Beijing, China
| | - Chao Yu
- Department of Cardiology, Peking University People's Hospital, Beijing, China
| | - Christopher L-H Huang
- Key Laboratory of Medical Electrophysiology of Ministry of Education, Institute of Cardiovascular Research, Southwest Medical University, Luzhou, China.,Physiological Laboratory, University of Cambridge, Cambridge, United Kingdom.,Department of Biochemistry, University of Cambridge, Cambridge, United Kingdom
| | - Dongyue Liu
- Department of Cardiology, Peking University People's Hospital, Beijing, China
| | - Wen Zheng
- Institute of Molecular Medicine, College of Future Technology, Peking University, Beijing, China.,Beijing Key Laboratory of Cardiometabolic Molecular Medicine, Peking University, Beijing, China
| | - Yuli Liu
- Institute of Molecular Medicine, College of Future Technology, Peking University, Beijing, China
| | - Xin Quan
- Department of Cardiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing, China
| | - Lingyun Kong
- Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Siying Liang
- Department of Cardiology, Peking University People's Hospital, Beijing, China
| | - Xiuqin Zhang
- Institute of Molecular Medicine, College of Future Technology, Peking University, Beijing, China.,Beijing Key Laboratory of Cardiometabolic Molecular Medicine, Peking University, Beijing, China
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9
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Zavadovskij KV, Saushkin VV, Varlamova YV, Mishkina AI, Shipulin VV, Lebedev DI, Popov SV. Mechanical Dyssynchrony for Prediction of the Cardiac Resynchronization Therapy Response in Patients with Dilated Cardiomyopathy. ACTA ACUST UNITED AC 2021; 61:14-21. [PMID: 34397337 DOI: 10.18087/cardio.2021.7.n1420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 03/12/2021] [Accepted: 04/15/2021] [Indexed: 11/18/2022]
Abstract
Aim To evaluate the predictive value of indexes of left ventricular mechanical dyssynchrony (MD) as determined by data of electrocardiogram (ECG)-gated myocardial perfusion scintigraphy (ECG-MPS) for prediction of the efficacy of resynchronization therapy (RT) in patients with chronic heart failure (CHF).Material and methods This prospective study included 32 patients with nonischemic CHF and standard indications for RT. All patients underwent complete clinical an instrumental examination, including 24-h ECG monitoring and echocardiography (EchoCG). In order to evaluate the left ventricular (LV) myocardial perfusion, contractile function, and MD, myocardial perfusion scintigraphy was performed for all patients at rest prior to RT. In addition to the perfusion defect size at rest and hemodynamic parameters, LV MD was determined. The following indexes were used for analysis of dyssynchronization: phase standard deviation (PSD), phase histogram bandwidth (HBW), and phase histogram asymmetry and steepness. The treatment efficacy was evaluated by the clinical status of patients (clinical condition evaluation scale for CHF patient) and EchoCG at 6 months following RT. The criteria for a positive response to RT were an increase in LV ejection fraction (EF) by 5% and/or a decrease in the LV end-diastolic volume by 15% compared to preoperative values.Results According to ECG-MPS findings, all patients had scintigraphic signs of severe CHF with dilated LV cavity (end-diastolic volume, EDV 246 [217; 269] ml) and also of pronounced mechanical and electrical dyssynchrony. The values of mechanical dyssynchrony were PSD 53 [41; 61], HBW 176 [136; 202], asymmetry 1.62 [1.21; 1.89], and steepness 2.81 [1.21; 3.49]. The QRS duration was 165 [155; 175] msec. Furthermore, the LV perfusion was moderately impaired (perfusion defect size 4 [3; 10] %). Mean follow-up duration after implantation of the resynchronizing device was 6±1.7 mos. According to the selected criteria, 20 (63 %) patients were considered as responders and 12 (37 %) patients as non-responders. Before implantation of the cardiac synchronizing device, responders and non-responders differed only in LV MD (PSD 44 [35; 54] vs. 63 [58; 72]; p=0.0001); HBW 158 [118; 179] vs. 205 [199; 249]; p=0.0001; asymmetry 1.77 [1.62; 2.02] vs. 1.21 [0.93; 1.31]; p=0.0001; steepness 3.03 [2.60; 3.58] vs. 1.21 [0.19; 1.46]; p=0.0001), respectively. A one-factor logistic regression analysis showed that MD values were statistically significant predictors of a positive response to RT. A multi-factor logistic analysis of phase histogram steepness (odds ratio, OR 1.196; 95 % confidence interval, CI 1.04-1.37) and PSD (OR 0.67; 95 % CI 0.47-0.97) were identified as independent predictors for the response to RT. According to results of the ROC analysis, a PSD <55 and a phase histogram steepness >1.54 may predict the effectiveness of RT (AUC= 0.92; р=0.0001).Conclusion LV MD parameters determined with ECG-MPS allow predicting the effectiveness of RT in patients with nonischemic CHF. In this patient group, high values of standard deviation and low values of phase histogram steepness were independent predictors for the absence of response to RT after 6 mos. of follow-up.
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Affiliation(s)
- K V Zavadovskij
- Cardiology Research Institute, Tomsk National Research Medical Center, Tomsk
| | - V V Saushkin
- Cardiology Research Institute, Tomsk National Research Medical Center, Tomsk
| | - Yu V Varlamova
- Cardiology Research Institute, Tomsk National Research Medical Center, Tomsk
| | - A I Mishkina
- Cardiology Research Institute, Tomsk National Research Medical Center, Tomsk
| | - V V Shipulin
- Cardiology Research Institute, Tomsk National Research Medical Center, Tomsk
| | - D I Lebedev
- Cardiology Research Institute, Tomsk National Research Medical Center, Tomsk
| | - S V Popov
- Cardiology Research Institute, Tomsk National Research Medical Center, Tomsk
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10
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Kuronuma K, Miller RJH, Otaki Y, Van Kriekinge SD, Diniz MA, Sharir T, Hu LH, Gransar H, Liang JX, Parekh T, Kavanagh PB, Einstein AJ, Fish MB, Ruddy TD, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, Di Carli M, Tamarappoo BK, Dey D, Berman DS, Slomka PJ. Prognostic Value of Phase Analysis for Predicting Adverse Cardiac Events Beyond Conventional Single-Photon Emission Computed Tomography Variables: Results From the REFINE SPECT Registry. Circ Cardiovasc Imaging 2021; 14:e012386. [PMID: 34281372 DOI: 10.1161/circimaging.120.012386] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Phase analysis of single-photon emission computed tomography myocardial perfusion imaging provides dyssynchrony information which correlates well with assessments by echocardiography, but the independent prognostic significance is not well defined. This study assessed the independent prognostic value of single-photon emission computed tomography-myocardial perfusion imaging phase analysis in the largest multinational registry to date across all modalities. METHODS From the REFINE SPECT (Registry of Fast Myocardial Perfusion Imaging With Next Generation SPECT), a total of 19 210 patients were included (mean age 63.8±12.0 years and 56% males). Poststress total perfusion deficit, left ventricular ejection fraction, and phase variables (phase entropy, bandwidth, and SD) were obtained automatically. Cox proportional hazards analyses were performed to assess associations with major adverse cardiac events (MACE). RESULTS During a follow-up of 4.5±1.7 years, 2673 (13.9%) patients experienced MACE. Annualized MACE rates increased with phase variables and were ≈4-fold higher between the second and highest decile group for entropy (1.7% versus 6.7%). Optimal phase variable cutoff values stratified MACE risk in patients with normal and abnormal total perfusion deficit and left ventricular ejection fraction. Only entropy was independently associated with MACE. The addition of phase entropy significantly improved the discriminatory power for MACE prediction when added to the model with total perfusion deficit and left ventricular ejection fraction (P<0.0001). CONCLUSIONS In a largest to date imaging study, widely representative, international cohort, phase variables were independently associated with MACE and improved risk stratification for MACE beyond the prediction by perfusion and left ventricular ejection fraction assessment alone. Phase analysis can be obtained fully automatically, without additional radiation exposure or cost to improve MACE risk prediction and, therefore, should be routinely reported for single-photon emission computed tomography-myocardial perfusion imaging studies.
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Affiliation(s)
- Keiichiro Kuronuma
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA (K.K., R.J.H.M., Y.O., S.D.V.K., M.A.D., L.-H.H., H.G., J.X.L., T.P., P.B.K. B.K.T., D.D., D.S.B., P.J.S.).,Department of Cardiology, Nihon University, Tokyo, Japan (K.K.)
| | - Robert J H Miller
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA (K.K., R.J.H.M., Y.O., S.D.V.K., M.A.D., L.-H.H., H.G., J.X.L., T.P., P.B.K. B.K.T., D.D., D.S.B., P.J.S.).,Department of Cardiac Sciences, University of Calgary, Alberta, Canada (R.J.H.M.)
| | - Yuka Otaki
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA (K.K., R.J.H.M., Y.O., S.D.V.K., M.A.D., L.-H.H., H.G., J.X.L., T.P., P.B.K. B.K.T., D.D., D.S.B., P.J.S.)
| | - Serge D Van Kriekinge
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA (K.K., R.J.H.M., Y.O., S.D.V.K., M.A.D., L.-H.H., H.G., J.X.L., T.P., P.B.K. B.K.T., D.D., D.S.B., P.J.S.)
| | - Marcio A Diniz
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA (K.K., R.J.H.M., Y.O., S.D.V.K., M.A.D., L.-H.H., H.G., J.X.L., T.P., P.B.K. B.K.T., D.D., D.S.B., P.J.S.)
| | - Tali Sharir
- Department of Nuclear Cardiology, Assuta Medical Centers, Tel Aviv, and Ben Gurion University of the Negev, Beer Sheba, Israel (T.S.)
| | - Lien-Hsin Hu
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA (K.K., R.J.H.M., Y.O., S.D.V.K., M.A.D., L.-H.H., H.G., J.X.L., T.P., P.B.K. B.K.T., D.D., D.S.B., P.J.S.).,Department of Nuclear Medicine, Taipei Veterans General Hospital, Taiwan (L.-H.H.)
| | - Heidi Gransar
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA (K.K., R.J.H.M., Y.O., S.D.V.K., M.A.D., L.-H.H., H.G., J.X.L., T.P., P.B.K. B.K.T., D.D., D.S.B., P.J.S.)
| | - Joanna X Liang
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA (K.K., R.J.H.M., Y.O., S.D.V.K., M.A.D., L.-H.H., H.G., J.X.L., T.P., P.B.K. B.K.T., D.D., D.S.B., P.J.S.)
| | - Tejas Parekh
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA (K.K., R.J.H.M., Y.O., S.D.V.K., M.A.D., L.-H.H., H.G., J.X.L., T.P., P.B.K. B.K.T., D.D., D.S.B., P.J.S.)
| | - Paul B Kavanagh
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA (K.K., R.J.H.M., Y.O., S.D.V.K., M.A.D., L.-H.H., H.G., J.X.L., T.P., P.B.K. B.K.T., D.D., D.S.B., P.J.S.)
| | - Andrew J Einstein
- Division of Cardiology, Departments of Medicine and of Radiology, Columbia University Irving Medical Center and New York-Presbyterian Hospital (A.J.E.)
| | - Mathews B Fish
- Oregon Heart and Vascular Institute, Sacred Heart Medical Center, Springfield (M.B.F.)
| | - Terrence D Ruddy
- Division of Cardiology, University of Ottawa Heart Institute, ON, Canada (T.D.R.)
| | - Philipp A Kaufmann
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland (P.A.K.)
| | - Albert J Sinusas
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (A.J.S., E.J.M.)
| | - Edward J Miller
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (A.J.S., E.J.M.)
| | | | - Sharmila Dorbala
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, MA (S.D., M.D.C.)
| | - Marcelo Di Carli
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, MA (S.D., M.D.C.)
| | - Balaji K Tamarappoo
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA (K.K., R.J.H.M., Y.O., S.D.V.K., M.A.D., L.-H.H., H.G., J.X.L., T.P., P.B.K. B.K.T., D.D., D.S.B., P.J.S.)
| | - Damini Dey
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA (K.K., R.J.H.M., Y.O., S.D.V.K., M.A.D., L.-H.H., H.G., J.X.L., T.P., P.B.K. B.K.T., D.D., D.S.B., P.J.S.)
| | - Daniel S Berman
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA (K.K., R.J.H.M., Y.O., S.D.V.K., M.A.D., L.-H.H., H.G., J.X.L., T.P., P.B.K. B.K.T., D.D., D.S.B., P.J.S.)
| | - Piotr J Slomka
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA (K.K., R.J.H.M., Y.O., S.D.V.K., M.A.D., L.-H.H., H.G., J.X.L., T.P., P.B.K. B.K.T., D.D., D.S.B., P.J.S.)
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11
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Shimizu M, Iiya M, Fujii H, Kimura S, Suzuki M, Nishizaki M. Left ventricular end-systolic contractile entropy can predict cardiac prognosis in patients with complete left bundle branch block. J Nucl Cardiol 2021; 28:162-171. [PMID: 31087265 DOI: 10.1007/s12350-019-01739-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 04/19/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Several patients with complete left bundle branch block (CLBBB) show left ventricular (LV) dyssynchrony and poor cardiac prognosis. However, the prognostic value of LV end-systolic contractile entropy which was measured by single-photon emission computer tomography (SPECT) has not been elucidated in patients with CLBBB. METHODS AND RESULTS We recruited consecutive 115 sinus-rhythm patients with CLBBB who underwent ECG-gated 201TlCl-SPECT. After 30 days of observation, finally 102 patients (75.2 ± 9.5 years, 62 male) were enrolled and observed retrospectively for a median of 671 days. Twenty-five patients fell into major cardiac events. Multivariate Cox regression analysis showed estimated glomerular filtration rate (eGFR) ≤ 39.35 mL/min and entropy ≥ 79% were significant and independent predictors for major cardiac events (hazard ratio: 4.256 and 7.587, P value = 0.006 and < 0.001, respectively). Machine learning (Random Forest method) revealed eGFR and entropy had higher feature importance than other predictors (0.140 and 0.138, respectively). Kaplan-Meyer curve analysis demonstrated that the group with entropy ≥ 79% and eGFR ≤ 39.36 mL/min had the worst cardiac prognosis (Logrank: P = 0.002). CONCLUSIONS Left ventricular end-systolic contractile entropy predicts poor cardiac prognosis in patients with CLBBB, which may be more valuable than the other parameters of SPECT.
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Affiliation(s)
- Masato Shimizu
- Department of Cardiology, Yokohama Minami Kyosai Hospital, 1-21-1 Mutsuura-higashi, Kanazawa-ku, Yokohama, 236-0037, Japan.
| | - Munehiro Iiya
- Department of Cardiology, Yokohama Minami Kyosai Hospital, 1-21-1 Mutsuura-higashi, Kanazawa-ku, Yokohama, 236-0037, Japan
| | - Hiroyuki Fujii
- Department of Cardiology, Yokohama Minami Kyosai Hospital, 1-21-1 Mutsuura-higashi, Kanazawa-ku, Yokohama, 236-0037, Japan
| | - Shigeki Kimura
- Department of Cardiology, Yokohama Minami Kyosai Hospital, 1-21-1 Mutsuura-higashi, Kanazawa-ku, Yokohama, 236-0037, Japan
| | - Makoto Suzuki
- Department of Cardiology, Yokohama Minami Kyosai Hospital, 1-21-1 Mutsuura-higashi, Kanazawa-ku, Yokohama, 236-0037, Japan
| | - Mitsuhiro Nishizaki
- Kanto Gakuin University/Odawara Cardiovascular Hospital, Yokohama/Odawara, Japan
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12
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Salimian S. Left ventricular mechanical dyssynchrony under stress: Isn't it time to conduct a prospective multicenter study? J Nucl Cardiol 2020; 27:2258-2260. [PMID: 30656574 DOI: 10.1007/s12350-019-01599-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 12/28/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Samaneh Salimian
- Department of Biomedical Sciences, University of Montreal, Montreal, QC, Canada.
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13
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Port S. Taking a deeper dive into MPI: There's more there than meets the eye. J Nucl Cardiol 2020; 27:1592-1595. [PMID: 30627881 DOI: 10.1007/s12350-018-01588-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 11/30/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Steven Port
- Advocate Aurora Health, Aurora Cardiovascular Services, Milwaukee, WI, USA.
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14
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Left ventricular mechanical dyssynchrony analzyed by Tc-99m sestamibi SPECT and F-18 FDG PET in patients with ischemic cardiomyopathy and the prognostic value. Int J Cardiovasc Imaging 2020; 36:2063-2071. [DOI: 10.1007/s10554-020-01904-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 05/29/2020] [Indexed: 10/24/2022]
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15
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Wang C, Tang H, Zhu F, Jiang Z, Shi J, Zhou Y, Garcia EV, Li D, Zhou W. Prognostic value of left-ventricular systolic and diastolic dyssynchrony measured from gated SPECT MPI in patients with dilated cardiomyopathy. J Nucl Cardiol 2020; 27:1582-1591. [PMID: 30386981 PMCID: PMC10959400 DOI: 10.1007/s12350-018-01468-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 09/20/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Left-ventricular systolic dyssynchrony (LVSD) has been an important prognostic factor in the patients with dilated cardiomyopathy (DCM). However, the association between the LV diastolic dyssynchrony (LVDD) and clinical outcome is not well established. This study aims to evaluate the prognostic values of both systolic and diastolic dyssynchrony in patients with DCM. METHODS Fifty-two patients with DCM were enrolled and divided into two groups according to cardiac deaths from the follow-up data. The phase-analysis technique was applied on resting gated short-axis SPECT MPI images to measure LV systolic and diastolic dyssynchrony, including phase standard deviation (PSD), phase histogram bandwidth (PBW), and phase entropy (PE). Variables with P < 0.10 in the univariate analysis were included in the multivariate cox analysis. RESULTS During the follow-up period (2.9 ± 1.7 years), 18 (34.6%) cardiac deaths were observed. Compared with survivors, patients with cardiac death had lower LVEF (P = 0.011), and more severe LV systolic and diastolic dyssynchrony. The univariate cox regression analysis showed that hypertension, NT-proBNP, LVEF, systolic PSD, systolic PE, and diastolic PBW were statistically significantly associated with cardiac death. The multivariate cox regression analysis showed that systolic PE and diastolic PE were independent predictive factors for cardiac death. Furthermore, the receiver operating characteristic (ROC) analysis, when applied into the combination of systolic PE and diastolic PE for predicting cardiac death, had an area under curve (AUC) of 0.766, a sensitivity of 0.765, and a specificity of 0.722. CONCLUSIONS Both the LVSD and LVDD parameters from SPECT MPI have important prognostic values for DCM patients. Both systolic PE and diastolic PE are independent prognostic factors for cardiac death.
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Affiliation(s)
- Cheng Wang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Haipeng Tang
- School of Computing, University of Southern Mississippi, 730 East Beach Blvd, Long Beach, MS, 39560, USA
| | - Fubao Zhu
- School of Computer and Communication Engineering, Zhengzhou University of Light Industry, Zhengzhou, China
| | - Zhixin Jiang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Jianzhou Shi
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Yanli Zhou
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Ernest V Garcia
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia
| | - Dianfu Li
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
| | - Weihua Zhou
- School of Computing, University of Southern Mississippi, 730 East Beach Blvd, Long Beach, MS, 39560, USA.
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16
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Jiang Z, Zhou W. Left ventricular mechanical dyssynchrony for CAD diagnosis: Does it have incremental clinical values? J Nucl Cardiol 2020; 27:251-253. [PMID: 30218216 DOI: 10.1007/s12350-018-1440-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 08/31/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Zhixin Jiang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
| | - Weihua Zhou
- School of Computing, University of Southern Mississippi, Long Beach, MS, 39560, USA.
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17
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Lin WL, Wang SY, Shiau YC, Wu YW. The clinical usefulness of phase analysis in detecting coronary artery disease using dipyridamole thallium-201-gated myocardial perfusion imaging with a cadmium-zinc-telluride camera. J Nucl Cardiol 2020; 27:241-250. [PMID: 30171522 DOI: 10.1007/s12350-018-1417-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 08/02/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Previous studies have demonstrated left ventricular mechanical dyssynchrony (LVMD) in patients with severe coronary artery disease (CAD) with ≥ 70% stenosis. The aim of this study was to evaluate the clinical usefulness of stress/rest LVMD in the diagnosis of CAD with ≥ 50% stenosis using dipyridamole thallium-201 (Tl-201) myocardial perfusion imaging (MPI) with a cadmium-zinc-telluride camera. METHODS AND RESULTS A total of 476 patients without known CAD who underwent dipyridamole Tl-201 MPI and coronary angiography within 6 months were retrospectively reviewed. LVMD parameters including phase standard deviation and phase histogram bandwidth, phase skewness and phase kurtosis, as well as myocardial perfusion and myocardial stunning were assessed in post-stress and rest MPI. Relationships between the presence of CAD on coronary angiography and single photon emission computerized tomography (SPECT) parameters were evaluated. The presence of perfusion abnormalities was the best diagnostic tool in detecting CAD. Although less left ventricular synchrony was observed post-stress in the CAD group compared to the non-CAD group, no significant dyssynchrony was noted. CONCLUSIONS The addition of phase analysis to help diagnose CAD in Tl-201-gated SPECT with dipyridamole stress may have limited value in patients with CAD with ≥ 50% stenosis.
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Affiliation(s)
- Wan-Ling Lin
- Department of Nuclear Medicine, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, 220, Taiwan
- Department of Nuclear Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan
| | - Shan-Ying Wang
- Department of Nuclear Medicine, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, 220, Taiwan
| | - Yu-Chien Shiau
- Department of Nuclear Medicine, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, 220, Taiwan
| | - Yen-Wen Wu
- Department of Nuclear Medicine, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, 220, Taiwan.
- National Yang-Ming University School of Medicine, Taipei City, Taiwan.
- Department of Nuclear Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei City, Taiwan.
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18
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Marie PY, Rossignol P. Stress myocardial perfusion gated-SPECT imaging in advanced chronic kidney disease. J Nucl Cardiol 2019; 26:1971-1973. [PMID: 30350266 DOI: 10.1007/s12350-018-1412-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 05/21/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Pierre-Yves Marie
- CHRU-Nancy, Université de Lorraine, Nuclear Medicine & Nancyclotep Experimental Platform, Nancy, 54000, France.
- Université de Lorraine, INSERM, UMR-1116, Nancy, 54000, France.
| | - Patrick Rossignol
- Université de Lorraine, INSERM, UMR-1116, Nancy, 54000, France
- Université de Lorraine, CHRU-Nancy, INSERM 1433 Centre D'Investigation Clinique & FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, 54000, France
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19
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Zhou W, Hung GU. Left-ventricular mechanical dyssynchrony in the prognosis of dilated cardiomyopathy: Which parameter is more useful? J Nucl Cardiol 2018; 25:1688-1691. [PMID: 28361476 DOI: 10.1007/s12350-017-0863-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 03/20/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Weihua Zhou
- School of Computing, University of Southern Mississippi, Long Beach, MS, 39560, USA.
| | - Guang-Uei Hung
- Department of Nuclear Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan.
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