Key result
Phase analysis on gated myocardial perfusion SPECT showed good correlation with tissue Doppler imaging for the assessment of left ventricular diastolic dyssynchrony (r=0.81 for diastolic phase SD, p<0.01).
Why the study?
Does phase analysis on gated myocardial perfusion SPECT (GMPS) accurately assess left ventricular diastolic dyssynchrony compared to tissue Doppler imaging in patients with end-stage heart failure?
Cross-Sectional (n=150)
Blinded observers
No
Does phase analysis on gated myocardial perfusion SPECT (GMPS) accurately assess left ventricular diastolic dyssynchrony compared to tissue Doppler imaging in patients with end-stage heart failure?
Effect estimate: r=0.81
p-value: p=<0.01
Phase analysis on gated myocardial perfusion SPECT is a feasible and reproducible method for assessing LV diastolic dyssynchrony, showing good correlation with tissue Doppler imaging in patients with end-stage heart failure.
Supports GMPS phase analysis as alternative for LV diastolic dyssynchrony assessment; leaves open prospective outcome validation in end-stage HF.
PURPOSE: The aim of the current study was to evaluate the feasibility of phase analysis on gated myocardial perfusion SPECT (GMPS) for the assessment of left ventricular (LV) diastolic dyssynchrony in a head-to-head comparison with tissue Doppler imaging (TDI). METHODS: The population consisted of patients with end-stage heart failure of New York Heart Association functional class III or IV with a reduced LV ejection fraction of ≤ 35%. LV diastolic dyssynchrony was calculated using TDI as the maximal time delay between early peak diastolic velocities of two opposing left ventricle walls (diastolic mechanical delay). Significant LV diastolic dyssynchrony was defined as a diastolic mechanical delay of >55 ms on TDI. Furthermore, phase analysis on GMPS was performed to evaluate LV diastolic dyssynchrony; diastolic phase standard deviation (SD) and histogram bandwidth (HBW) were used as markers of LV diastolic dyssynchrony. RESULTS: A total of 150 patients (114 men, mean age 66.0 ± 10.4 years) with end-stage heart failure were enrolled. Both diastolic phase SD (r = 0.81, p < 0.01) and diastolic HBW (r = 0.75, p < 0.01) showed good correlations with LV diastolic dyssynchrony on TDI. Additionally, patients with LV diastolic dyssynchrony on TDI (>55 ms) showed significantly larger diastolic phase SD (68.1 ± 13.4° vs. 40.7 ± 14.0°, p < 0.01) and diastolic HBW (230.6 ± 54.3° vs. 129.0 ± 55.6°, p < 0.01) as compared to patients without LV diastolic dyssynchrony on TDI (≤ 55 ms). Finally, phase analysis on GMPS showed a good intra- and interobserver reproducibility for the determination of diastolic phase SD (ICC 0.97 and 0.88) and diastolic HBW (ICC 0.98 and 0.93). CONCLUSION: Phase analysis on GMPS showed good correlations with TDI for the assessment of LV diastolic dyssynchrony.
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Boogers et al. (2011) conducted a cross-sectional in End-stage heart failure (n=150). Phase analysis on gated myocardial perfusion SPECT (GMPS) vs. Tissue Doppler imaging (TDI) was evaluated on Correlation between diastolic phase standard deviation on GMPS and diastolic mechanical delay on TDI (r=0.81, p=<0.01). Phase analysis on gated myocardial perfusion SPECT showed good correlation with tissue Doppler imaging for the assessment of left ventricular diastolic dyssynchrony (r=0.81 for diastolic phase SD, p<0.01).
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