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Graner FP, Fischer M, Ilhan H, Bartenstein P, Todica A, Lehner S. Assessment of left ventricular function with gated myocardial perfusion SPECT and gated myocardial FDG PET in patients with left ventricular mechanical dyssynchrony. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF... 2023; 67:230-237. [PMID: 34881846 DOI: 10.23736/s1824-4785.21.03398-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Left ventricular mechanical dyssynchrony (LVMD) and left ventricular function are intertwined. Gated myocardial perfusion SPECT (MPS) and gated fluorodeoxyglucose positron emission computed tomography (FDG PET) is an elegant way for repeated assessment of myocardial dyssynchrony and myocardial function. To the knowledge of the authors at the time this manuscript was prepared, there was no comprehensive evaluation of the interplay of LVMD and left ventricular function as measured by gated MPS and gated FDG PET; as well as no evaluation of the agreement between the two methods. METHODS Patients were assigned to the reference cohort (RC) and the dyssynchrony cohort (DC) based on the phase analysis results of gated MPS datasets. Subsequently left ventricular function was analyzed. RESULTS We demonstrated that LVMD as detected by gated MPS is associated with a significantly higher end-diastolic volume (EDV) and end-systolic volume (ESV) as well as a significantly reduced left ventricular ejection fraction (LVEF) both in gated MPS and gated FDG PET imaging. In the RC and the DC SPECT and PET showed good agreement and generally high linear correlations with regard to left ventricular volumes and LVEF. In the combined cohort (RC and DC) increasing amounts of LVMD were associated with increasing left ventricular volumes as well as a decreasing LVEF. The association was strongest for the dyssynchrony parameter Entropy. CONCLUSIONS We demonstrated that gated SPECT and gated PET are useful tools in the evaluation of left ventricular function in patients with LVMD as detected by gated MPS. Increasing amounts of dyssynchrony were associated with an increasingly reduced myocardial function. For repeated measurements or therapy monitoring, the methods should not be used interchangeably.
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Affiliation(s)
- Frank P Graner
- Department of Nuclear Medicine, University Hospital Munich, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Maximilian Fischer
- Department of Cardiology, University Hospital Munich, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Harun Ilhan
- Department of Nuclear Medicine, University Hospital Munich, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital Munich, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Andrei Todica
- Department of Nuclear Medicine, University Hospital Munich, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Sebastian Lehner
- Department of Nuclear Medicine, University Hospital Munich, Ludwig-Maximilians-University Munich, Munich, Germany -
- Ambulatory Health Care Center Dr. Neumaier & Colleagues, Radiology, Nuclear Medicine, Radiation Therapy, Regensburg, Germany
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Xu H, Peng W, Yang Z, Zhang Y, Xia C, Li Z, Xu R, Guo Y. The association of secondary hyperparathyroidism and myocardial damages in hemodialysis end-stage renal disease patients: assessed by cardiovascular magnetic resonance native T1 mapping. J Cardiovasc Magn Reson 2021; 23:23. [PMID: 33691727 PMCID: PMC7949248 DOI: 10.1186/s12968-021-00713-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 01/26/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Secondary hyperparathyroidism is a common complication of end-stage renal disease (ESRD), which may be associated with cardiovascular diseases. Thus, this study aimed to explore myocardial damage using non-contrast cardiovascular magnetic resonance (CMR) in ESRD patients undergoing hemodialysis and further investigate its relationship with parathyroid hormone (PTH) toxicity. METHODS Seventy-two adult ESRD patients receiving regular hemodialysis and 30 healthy subjects underwent CMR examination. Continuous CMR cine sections from the mitral valve level to the left ventricular (LV) apex in the short-axis plane, cine series of vertical two-chamber long-axis plane, and horizontal four-chamber plane were acquired. Native T1 mapping was obtained using modified Look-Locker inversion recovery (MOLLI) sequences. Native T1 values and myocardial strain were analyzed. Immunoreactive parathyroid hormone (iPTH) was obtained from all enrolled patients. RESULTS Forty (55.6%) hemodialysis ESRD patients were found to have increased iPTH levels. LV ejection fraction (LVEF) of both ESRD patients with targeted and increased iPTH levels was decreased compared with healthy subjects (55.9 ± 12.0% vs. 65.0 ± 4.5%; 51.7 ± 12.8 vs. 65.0 ± 4.5%, both P < 0.05). The mean peak radial strain (PRS), peak circumferential strain (PCS), and peak longitudinal strain (PLS) were lowest in ESRD patients with increased iPTH; however, no significant difference was observed among these three groups. Segmentally, from base to apex, the native T1 of ESRD patients with increased iPTH levels tended to be higher than those with targeted iPTH and healthy subjects (all P < 0.05). In ESRD patients with targeted iPTH, both native T1 of basal and middle segments were significantly higher than normal subjects (basal, 1304 ± 41 ms vs. 1238 ± 36 ms, P = 0.001; middle, 1300 ± 43 ms vs. 1242 ± 50 ms, P < 0.001). Comparing global native T1 values in the three groups, ESRD patients with targeted and increased iPTH level showed increased native T1 (1305 ± 41 ms vs. 1251 ± 49 ms, P = 0.001; 1334 ± 40 ms vs. 1251 ± 49 ms, P < 0.001, respectively). Native T1 values of the basal segment and global native T1 were moderately associated with iPTH (r = 0.4, P < 0.001; r = 0.5, P < 0.001). Multiple linear regression analysis showed that global native T1 values (beta = 1.0, P = 0.01) were independently associated with iPTH. CONCLUSIONS Elevated iPTH level was associated with and was an independent risk factor for myocardial damage in ESRD patients undergoing maintenance hemodialysis. TRIAL REGISTRATION Chinese Clinical Trial Registry ( http://www.chictr.org.cn/index.aspx ) ChiCTR-DND-17012976, 13/12/2017, retrospectively registered.
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Affiliation(s)
- Huayan Xu
- Department of Radiology, West China Second University Hospital, Sichuan University, 20# South Ren min Road, Chengdu, 610041, Sichuan, China
- Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, 20# South Ren min Road, Chengdu, 610041, Sichuan, China
| | - Wanlin Peng
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Zhigang Yang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Yi Zhang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Chunchao Xia
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Zhenlin Li
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Rong Xu
- Department of Radiology, West China Second University Hospital, Sichuan University, 20# South Ren min Road, Chengdu, 610041, Sichuan, China
- Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, 20# South Ren min Road, Chengdu, 610041, Sichuan, China
| | - Yingkun Guo
- Department of Radiology, West China Second University Hospital, Sichuan University, 20# South Ren min Road, Chengdu, 610041, Sichuan, China.
- Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, 20# South Ren min Road, Chengdu, 610041, Sichuan, China.
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