Key result
Diastolic dyssynchrony was significantly elevated even in early-stage heart failure patients compared to controls, though it did not correlate with plasma BNP levels, whereas systolic dyssynchrony did correlate with BNP.
Cross-Sectional (n=64)
No
ECG-gated myocardial perfusion SPECT can detect diastolic dyssynchrony even in early-stage heart failure, while systolic dyssynchrony correlates with plasma BNP levels.
Supports SPECT assessment of diastolic dyssynchrony in early HF; leaves open its prognostic value beyond BNP.
BACKGROUND: A novel program, "cardioGRAF", has been developed to analyze regional left ventricular (LV) systolic/diastolic function and dyssynchrony, so the present study aimed to use it confirm the presence of LV dyssynchrony, and to correlate LV function and dyssynchrony with plasma B-type natriuretic peptide (BNP) levels during the early to advanced stages of heart failure (HF). METHODS AND RESULTS: Fourteen control subjects (G-C) and 50 patients (New York Heart Association functional class I: G-1, 21 patients; class II: G-2, 15 patients; and class III: G-3, 14 patients) were examined by ECG-gated myocardial perfusion single-photon emission computed tomography, using the new index of dyssynchrony, maximal difference (MD), which is the difference between the earliest and latest temporal parameters among 17 segments. First-third filling rate (FR) and the MD of time to peak FR revealing diastolic dyssynchrony were significantly different between G-C subjects and G-1 patients. Ejection fraction, peak ejection rate, peak FR, MD of time to end-systole, and MD of time to peak ejection rate were significantly correlated with plasma BNP levels. CONCLUSION: Diastolic dyssynchrony was demonstrated even in the early stage of HF, but, although not correlated with the plasma BNP level, systolic dyssynchrony might affect it.
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Takahashi et al. (2008) conducted a cross-sectional in Heart Failure (n=64). Heart failure (early to advanced stages) vs. Control subjects without heart failure was evaluated on Maximal difference of time from end systole to peak filling (MD-TPF1) as an index of diastolic dyssynchrony (p=<0.01). Diastolic dyssynchrony was significantly elevated even in early-stage heart failure patients compared to controls, though it did not correlate with plasma BNP levels, whereas systolic dyssynchrony did correlate with BNP.
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