Assessment of Left Ventricular Dyssynchrony During Development of Heart Failure by a Novel Program Using ECG-Gated Myocardial Perfusion SPECT

Takahashi, Naoto; Yamamoto, Akira; Tezuka, Shingo; Ishikawa, Masahiro; Abe, Junko; Amitani, Kenichi; Yamaguchi, Taizo; Kawaguchi, Naomi; Uchida, Takahiro; Iwahara, Shin-ichiro; Munakata, Kazuo

doi:10.1253/circj.72.370

Cited by 21 publications

(16 citation statements)

References 32 publications

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“…Recent studies suggest that LV dyssynchrony is also common in patients with narrow QRS and heart failure with preserved EF 19 , as well as those with hypertension with LV hypertrophy 20 .…”

Section: Discussionmentioning

confidence: 99%

Long-term Hemodialysis Corrects Left Ventricular Dyssynchrony in End-stage Renal Disease: A Study with Gated Technetium-99m Sestamibi Myocardial Perfusion Single-photon Emission Computed Tomography

et al. 2015

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Introduction: Left ventricular (LV) dyssynchrony is common in patients with end-stage renal disease (ESRD), and echocardiographic assessment has shown that it can be improved by a single session of hemodialysis (HD). The aim of this study was to assess the effects of chronic HD on LV dyssynchrony in patients ESRD by means of gated technetium-99m sestamibi myocardial perfusion single-photon emission computed tomography (GSPECT) with phase analysis. Materials and Methods:Twelve patients with ESRD underwent GSPECT and echocardiography before the start of long-term HD (baseline) and 3 months later. In addition, 7 control subjects matched for age and sex underwent GSPECT and echocardiography within a 2-month period. To evaluate LV dyssynchrony, both histogram bandwidth (HBW) and phase standard deviation (PSD) were determined with phase analysis of GSPECT images. The end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction were also measured with GSPECT, and the LV mass index (LVMI) was measured with echocardiography. The LV dyssynchrony, volume, function, and mass were compared among control subjects, patients with ESRD at baseline, and patients with ESRD after 3 months of chronic HD. Results:The LV dyssynchrony, volume, and mass at baseline were significantly greater in patients with ESRD than in control subjects (HBW, 65

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“…Recent studies suggest that LV dyssynchrony is also common in patients with narrow QRS and heart failure with preserved EF 19 , as well as those with hypertension with LV hypertrophy 20 .…”

Section: Discussionmentioning

confidence: 99%

Long-term Hemodialysis Corrects Left Ventricular Dyssynchrony in End-stage Renal Disease: A Study with Gated Technetium-99m Sestamibi Myocardial Perfusion Single-photon Emission Computed Tomography

et al. 2015

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“…[14][15][16][17][18] Furthermore, recent studies showed that the BNP level predicted subsequent prognosis not only in patients with heart failure but also in those with CAD. 1,3,4 In the present posthoc analysis of the Q-PROVE study, a high BNP level >130 pg/ml was significantly associated with subsequent cardiac events in 102 elderly patients with known or suspected CAD.…”

Section: Discussionmentioning

confidence: 99%

Comparative Impact of Scintigraphic Parameters and B-Type Natriuretic Peptide for the Prediction of Major Cardiac Events in the QGS-Prognostic Value in the Elderly (Q-PROVE) Study

Igarashi

Chikamori

Hida

et al. 2009

Circ J

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lthough B-type natriuretic peptide (BNP) has emerged as an important predictor not only for heart failure but also for myocardial ischemic events, 1-4 its effect on scintigraphic parameters derived from single-photon emission computed tomography (SPECT) is unknown. We previously reported in the Quantitative gated SPECT Prognostic Value in the Elderly (Q-PROVE) study that stress myocardial SPECT successfully stratified the risk for subsequent cardiac events in 175 elderly patients with a mean age of 79 years. 5 In addition to the prognostic value of myocardial SPECT, therefore, we performed a post-hoc analysis of the Q-PROVE study to elucidate the prognostic value of BNP in elderly patients with known or suspected coronary artery disease (CAD). Methods SubjectsThe Q-PROVE study initially enrolled 182 elderly patients aged 75-85 years from 11 institutions. 5 Consecutive elderly patients who underwent gated SPECT in each institution for the evaluation of known or suspected CAD because of clinical symptoms, multiple coronary risk factors or abnormal ECG were eligible for enrollment. The following were the exclusion criteria: (1) age <75 years or >85 years, (2) acute heart failure, (3) atrial fibrillation, (4) acute myocardial infarction within 3 months before the SPECT study, (5) coronary revascularization within 3 months after the SPECT study, (6) serious concomitant hepatic or renal disease, (7) malignancy or any other illness with a poor prognosis. Of the 182 patients who participated in this study, 3 patients underwent coronary revascularization within 3 months after the SPECT study, and 4 patients were lost to follow-up. In addition, BNP was not measured within 3 months of the study in 73 patients, which left 102 patients for this post-hoc analysis. Study ProtocolApplying the inclusion and exclusion criteria for the Q-PROVE study, patients were prospectively evaluated by primary physicians, cardiologists or both who were responsible for the SPECT study, and who assessed the past medical history including classical coronary risk factors. The patients underwent stress/rest myocardial perfusion Comparative Impact of Scintigraphic Parameters and B-Type Natriuretic Peptide for the Prediction of Major Cardiac Events in the QGS-Prognostic Value in the Elderly (Q-PROVE) StudyYuko Igarashi, MD; Taishiro Chikamori, MD; Satoshi Hida, MD; Tadashi Nagao, MD; Hirokazu Tanaka, MD; Yasuhiro Usui, MD; Tsuguhisa Hatano, MD; Takayuki Morishima, MD; Hidefumi Yanagisawa, MD; Akira Yamashina, MD Background: Although B-type natriuretic peptide (BNP) has emerged as an important predictor for cardiac events, its effect on scintigraphic parameters is unknown. Methods and Results:The Q-PROVE study is a multicenter study to evaluate the prognostic value of ECG-gated SPECT in 175 Japanese elderly patients. In addition, BNP was assessed in 102 patients. Outcome assessment included cardiac events and noncardiac deaths. Twelve elderly patients (12%) had increased BNP >130 pg/ml. The summed stress score (SSS) was greater in patients with incr...

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“…10 The LV is divided into (Received April 27, 2008; revised manuscript received August 5, 2008; accepted August 19, 2008; released online January 9, 2009) Departments of Cardiology, *Cardiovascular Surgery, Edogawa Hospital and **Medtronic Japan Co Ltd, Tokyo, Japan Mailing address: Takehiko Keida, MD, Department of Cardiology, Edogawa Hospital, 2-24-18 Higashi Koiwa, Edogawa-ku, Tokyo 133-0052, Japan. E-mail: keida@edogawa.or.jp All rights are reserved to the Japanese Circulation Society.…”

Section: Case Report Data Acquisition and Analysis With Cardiografmentioning

confidence: 99%

“…10 The LV is divided into 17 volume segments, 11 and the regional wall motion and change in myocardial wall thickening of each segment are estimated. [12][13][14] The variation in volume over time is measured for each segment, where the onset of a cardiac rhythm is triggered on the peak of the R-wave, and the instant of end-systole is detected using the zero-crossing detection on the first-derivative of the time-volume curve (ie, contraction velocity.…”

Section: Case Report Data Acquisition and Analysis With Cardiografmentioning

confidence: 99%

Quantitative Assessment of Dyssynchrony Using ECG-Gated SPECT Myocardial Perfusion Imaging Prior to and Following Cardiac Resynchronization Therapy

Keida

Ohira

Fujita

et al. 2009

Circ J

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Circ J 2009; 73: 1550 -1553 ardiac resynchronization therapy (CRT) is considered to be effective in patients with moderate to advanced heart failure (HF) and ventricular dyssynchrony defined by a prolonged QRS duration, but there are reports that CRT does not improve the medical condition of approximately 30% of HF patients. 1,2 The efficacy of CRT in HF is mainly based on the minimization of mechanical dyssynchrony in the left ventricle (LV) by biventricular pacing, in which case, the selection of patients according to the present indications for the therapy (ie, New York Heart Association (NYHA) functional class III or IV; unimproved symptoms despite optimal medical treatment; depressed LV ejection fraction (EF ≤35%); QRS duration ≥130 ms) may be imprecise, because the evaluation of LV dyssynchrony is only assessed by 1 surrogate indicator, the QRS duration. Although a wide QRS complex signifying electromechanical delay has been associated with favorable prognosis in HF patients undergoing CRT, estimation of LV dyssynchrony by a simple measure on the ECG often leads to an inaccurate evaluation. 3 The lack of correlation between the QRS duration and ventricular dyssynchrony demonstrates that the standard ECG measure is a reflection on the body surface of the total duration of ventricular activation and hence not a specific index of synchrony/dyssynchrony, which implies that complex and varied heterogeneous mechanical responses to electrical resynchronization exist among individuals. 4 A more direct determinant of dyssynchrony should be determined, using imaging techniques that detect minor regional and local change in mass that otherwise do not influence QRS morphology in a standard measurement, given its unsubstantial volume. 5 Echocardiography is currently regarded as the tool for determining mechanical dyssynchrony, and therefore the eventual response to CRT; 6,7 however, effective indices for the classification of patients with respect to the efficacy of CRT is not yet established. 8 Phase analysis of ECG-gated SPECT myocardial perfusion imaging has been compared with other methods and shown promising results for clinical evaluation. 9 It has been suggested that a measure based on the phase distribution of the onset of LV contraction in perfusion imaging would predict the response to CRT and should therefore demonstrate its applicability in the clinical setting. We used a software program called cardioGRAF ® (FUJIFILM RI Pharma Co, Ltd, Tokyo, Japan) to process perfusion imaging data recorded with ECG-gated SPECT as a new, noninvasive method of analyzing LV dyssynchrony. The dispersion of regional systolic timing was studied and is proposed as an expression of LV dyssynchrony for evaluating the response to CRT. Case Report Data Acquisition and Analysis With CardioGRAFRegional contraction timing in LV was computed and visualized with the cardioGRAF software, which processes imaging data acquired by ECG-gated myocardial perfusion SPECT as described previously. 10 The LV is divided into (Received April 27, 20...

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Assessment of Left Ventricular Dyssynchrony During Development of Heart Failure by a Novel Program Using ECG-Gated Myocardial Perfusion SPECT

Cited by 21 publications

References 32 publications

Long-term Hemodialysis Corrects Left Ventricular Dyssynchrony in End-stage Renal Disease: A Study with Gated Technetium-99m Sestamibi Myocardial Perfusion Single-photon Emission Computed Tomography

Long-term Hemodialysis Corrects Left Ventricular Dyssynchrony in End-stage Renal Disease: A Study with Gated Technetium-99m Sestamibi Myocardial Perfusion Single-photon Emission Computed Tomography

Comparative Impact of Scintigraphic Parameters and B-Type Natriuretic Peptide for the Prediction of Major Cardiac Events in the QGS-Prognostic Value in the Elderly (Q-PROVE) Study

Quantitative Assessment of Dyssynchrony Using ECG-Gated SPECT Myocardial Perfusion Imaging Prior to and Following Cardiac Resynchronization Therapy

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