Skip to main content
Top
Published in: Journal of Nuclear Cardiology 5/2010

01-10-2010 | Original Article

Repeatability of left ventricular dyssynchrony and function parameters in serial gated myocardial perfusion SPECT studies

Authors: Xianhe Lin, MD, PhD, Huiqin Xu, MD, Xuefeng Zhao, MD, Russell D. Folks, BS, CNMT, Ernest V. Garcia, PhD, Prem Soman, MD, PhD, Ji Chen, PhD

Published in: Journal of Nuclear Cardiology | Issue 5/2010

Login to get access

Abstract

Background

The purpose of this study was to establish the repeatability of left-ventricular (LV) dyssynchrony and function parameters measured from serial gated myocardial perfusion SPECT (GMPS) studies.

Methods

Thirty patients, who met standard criteria for cardiac resynchronization therapy (CRT), were prospectively enrolled. One hour after resting injection, a standard GMPS was performed, and repeated 30 minutes later after repositioning the patient. The two serial studies were processed blinded from each other by an experienced operator, and processed side-by-side by another experienced operator using iterative reconstruction, Butterworth filtering, and the Emory Cardiac Toolbox with phase analysis. Phase standard deviation, phase histogram bandwidth, LV ejection fraction, end-systolic volume, and end-diastolic volume were calculated and compared.

Results

All measured parameters were highly correlated (r > .90) between the serial studies without significant difference by paired t test. The variations of the parameters measured by side-by-side processing were significantly smaller than those measured by blinded processing.

Conclusion

These results indicated high repeatability of LV dyssynchrony and function parameters when measured serially by GMPS, especially when the serial studies were processed side-by-side. The measured variations of these parameters can be used to evaluate changes in LV dyssynchrony and function measured by GMPS before and after CRT.
Literature
1.
go back to reference Abraham WT, Hayes DL. Cardiac resynchronization therapy for heart failure. Circulation 2003;108:2596-603.CrossRefPubMed Abraham WT, Hayes DL. Cardiac resynchronization therapy for heart failure. Circulation 2003;108:2596-603.CrossRefPubMed
2.
go back to reference Higgins SL, Hummel JD, Niazi IK, Giudici MC, Worley SJ, Saxon LA, Boehmer JP, Higginbotham MB, De Marco T, Foster E, Yong PG. Cardiac resynchronization therapy for the treatment of heart failure in patients with intraventricular conduction delay and malignant ventricular tachyarrhythmias. J Am Coll Cardiol 2003;42:1454-9.CrossRefPubMed Higgins SL, Hummel JD, Niazi IK, Giudici MC, Worley SJ, Saxon LA, Boehmer JP, Higginbotham MB, De Marco T, Foster E, Yong PG. Cardiac resynchronization therapy for the treatment of heart failure in patients with intraventricular conduction delay and malignant ventricular tachyarrhythmias. J Am Coll Cardiol 2003;42:1454-9.CrossRefPubMed
3.
go back to reference Young JB, Abraham WT, Smith AL, Leon AR, Lieberman R, Wilkoff B, Canby RC, Schroeder JS, Liem LB, Hall S. Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: The MIRACLE ICD Trial. JAMA 2003;289:2685-94.CrossRefPubMed Young JB, Abraham WT, Smith AL, Leon AR, Lieberman R, Wilkoff B, Canby RC, Schroeder JS, Liem LB, Hall S. Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: The MIRACLE ICD Trial. JAMA 2003;289:2685-94.CrossRefPubMed
4.
go back to reference McAlister F, Ezekowitz J, Wiebe N, Rowe B, Spooner C, Crumley E, Hartling L, Kaul P, Nichol G, Klassen T. Cardiac resynchronization therapy for congestive heart failure. Evid Rep Technol Assess (Summ) 2004;106:1-8. McAlister F, Ezekowitz J, Wiebe N, Rowe B, Spooner C, Crumley E, Hartling L, Kaul P, Nichol G, Klassen T. Cardiac resynchronization therapy for congestive heart failure. Evid Rep Technol Assess (Summ) 2004;106:1-8.
5.
go back to reference Bristow MR, Saxon LA, Boehmer J, Krueger S, Kass DA, De Marco T, Carson P, DiCarlo L, DeMets D, White BG, DeVries DW. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med 2004;350:2140-50.CrossRefPubMed Bristow MR, Saxon LA, Boehmer J, Krueger S, Kass DA, De Marco T, Carson P, DiCarlo L, DeMets D, White BG, DeVries DW. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med 2004;350:2140-50.CrossRefPubMed
6.
go back to reference Cleland JG, Daubert JC, Erdmann E, Freemantle N, Gras D, Kappenberger L, Tavazzi L. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med 2005;352:1539-49.CrossRefPubMed Cleland JG, Daubert JC, Erdmann E, Freemantle N, Gras D, Kappenberger L, Tavazzi L. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med 2005;352:1539-49.CrossRefPubMed
7.
go back to reference Leclercq C, Kass DA. Retiming the failing heart: Principles and current clinical status of cardiac resynchronization. J Am Coll Cardiol 2002;39:194-201.CrossRefPubMed Leclercq C, Kass DA. Retiming the failing heart: Principles and current clinical status of cardiac resynchronization. J Am Coll Cardiol 2002;39:194-201.CrossRefPubMed
8.
go back to reference Auricchio A, Stellbrink C, Block M, Sack S, Vogt J, Bakker P, et al. Effect of pacing chamber and atrioventricular delay on acute systolic function of paced patients with congestive heart failure. The Pacing Therapies for Congestive Heart Failure Study Group. The Guidant Congestive Heart Failure Research Group. Circulation 1999;99:2993-3001.PubMed Auricchio A, Stellbrink C, Block M, Sack S, Vogt J, Bakker P, et al. Effect of pacing chamber and atrioventricular delay on acute systolic function of paced patients with congestive heart failure. The Pacing Therapies for Congestive Heart Failure Study Group. The Guidant Congestive Heart Failure Research Group. Circulation 1999;99:2993-3001.PubMed
9.
go back to reference Brecker SJ, Xiao HB, Sparrow J, et al. Effects of dual-chamber pacing with short atrioventricular delay in dilated cardiomyopathy. Lancet 1992;340:1308-12.CrossRefPubMed Brecker SJ, Xiao HB, Sparrow J, et al. Effects of dual-chamber pacing with short atrioventricular delay in dilated cardiomyopathy. Lancet 1992;340:1308-12.CrossRefPubMed
10.
go back to reference Leclercq C, Faris O, Tunin R, et al. Systolic Improvement and mechanical resynchronization does not require electrical synchrony in the dilated failing heart with left bundle-branch block. Circulation 2002;106:1760-3.CrossRefPubMed Leclercq C, Faris O, Tunin R, et al. Systolic Improvement and mechanical resynchronization does not require electrical synchrony in the dilated failing heart with left bundle-branch block. Circulation 2002;106:1760-3.CrossRefPubMed
11.
go back to reference Achilli A, Sassara M, Ficili S, et al. Long-term effectiveness of cardiac resynchronization therapy in patients with refractory heart failure and “narrow” QRS. J Am Coll Cardiol 2003;42:2117-24.CrossRefPubMed Achilli A, Sassara M, Ficili S, et al. Long-term effectiveness of cardiac resynchronization therapy in patients with refractory heart failure and “narrow” QRS. J Am Coll Cardiol 2003;42:2117-24.CrossRefPubMed
12.
go back to reference Bax JJ, Bleeker GB, Marwick TH, Molhoek SG, Boersma E, Steendijk P, et al. Left ventricular dyssynchrony predicts response and prognosis after cardiac resynchronization therapy. J Am Coll Cardiol 2004;44:1834-40.CrossRefPubMed Bax JJ, Bleeker GB, Marwick TH, Molhoek SG, Boersma E, Steendijk P, et al. Left ventricular dyssynchrony predicts response and prognosis after cardiac resynchronization therapy. J Am Coll Cardiol 2004;44:1834-40.CrossRefPubMed
13.
go back to reference Bax JJ, Marwick TH, Molhoek SG, Bleeker GB, van Erven L, Boersma E, et al. Left ventricular dyssynchrony predicts benefit of cardiac resynchronization therapy in patients with end-stage heart failure before pacemaker implantation. Am J Cardiol 2003;92:1238-40.CrossRefPubMed Bax JJ, Marwick TH, Molhoek SG, Bleeker GB, van Erven L, Boersma E, et al. Left ventricular dyssynchrony predicts benefit of cardiac resynchronization therapy in patients with end-stage heart failure before pacemaker implantation. Am J Cardiol 2003;92:1238-40.CrossRefPubMed
14.
go back to reference Bleeker GB, Mollema SA, Holman ER, Van d, Ypenburg C, Boersma E, et al. Left ventricular resynchronization is mandatory for response to cardiac resynchronization therapy: Analysis in patients with echocardiographic evidence of left ventricular dyssynchrony at baseline. Circulation 2007;116:1440-8. Bleeker GB, Mollema SA, Holman ER, Van d, Ypenburg C, Boersma E, et al. Left ventricular resynchronization is mandatory for response to cardiac resynchronization therapy: Analysis in patients with echocardiographic evidence of left ventricular dyssynchrony at baseline. Circulation 2007;116:1440-8.
15.
go back to reference Chung ES, Leon AR, Tavazzi L, et al. Results of the Predictors of Response to CRT (PROSPECT) trial. Circulation 2008;117:2608-16.CrossRefPubMed Chung ES, Leon AR, Tavazzi L, et al. Results of the Predictors of Response to CRT (PROSPECT) trial. Circulation 2008;117:2608-16.CrossRefPubMed
16.
go back to reference Chen J, Garcia EV, Folks RD, Cooke CD, Faber TL, Tauxe EL, Iskandrian AE. Onset of left ventricular mechanical contraction as determined by phase analysis of ECG-gated myocardial perfusion SPECT imaging: Development of a diagnostic tool for assessment of cardiac mechanical dyssynchrony. J Nucl Cardiol 2005;12:687-95.CrossRefPubMed Chen J, Garcia EV, Folks RD, Cooke CD, Faber TL, Tauxe EL, Iskandrian AE. Onset of left ventricular mechanical contraction as determined by phase analysis of ECG-gated myocardial perfusion SPECT imaging: Development of a diagnostic tool for assessment of cardiac mechanical dyssynchrony. J Nucl Cardiol 2005;12:687-95.CrossRefPubMed
17.
go back to reference Chen J, Faber TL, Cooke CD, Garcia EV. Temporal resolution of multi-harmonic phase analysis of ECG-gated myocardial perfusion SPECT studies. J Nucl Cardiol 2008;15:383-91.CrossRefPubMed Chen J, Faber TL, Cooke CD, Garcia EV. Temporal resolution of multi-harmonic phase analysis of ECG-gated myocardial perfusion SPECT studies. J Nucl Cardiol 2008;15:383-91.CrossRefPubMed
18.
go back to reference Trimble MA, Smalheiser S, Bornes-neto S, Chen J, et al. Evaluation of left ventricular mechanical dyssynchrony as determined by phase analysis of ECG-gated myocardial perfusion SPECT imaging in patients with left ventricular dysfunction and conduction disturbances. J Nucl Cardiol 2007;14:298-307.CrossRefPubMed Trimble MA, Smalheiser S, Bornes-neto S, Chen J, et al. Evaluation of left ventricular mechanical dyssynchrony as determined by phase analysis of ECG-gated myocardial perfusion SPECT imaging in patients with left ventricular dysfunction and conduction disturbances. J Nucl Cardiol 2007;14:298-307.CrossRefPubMed
19.
go back to reference Henneman MM, Chen J, Ypenburg C, Dibbets P, Stokkel M, van der Wall EE, Garcia EV, Bax JJ. Phase analysis of gated myocardial perfusion SPECT compared to tissue Doppler imaging for the assessment of left ventricular dyssynchrony. J Am Coll Cardiol 2007;49:1708-14.CrossRefPubMed Henneman MM, Chen J, Ypenburg C, Dibbets P, Stokkel M, van der Wall EE, Garcia EV, Bax JJ. Phase analysis of gated myocardial perfusion SPECT compared to tissue Doppler imaging for the assessment of left ventricular dyssynchrony. J Am Coll Cardiol 2007;49:1708-14.CrossRefPubMed
20.
go back to reference Henneman MM, Chen J, Dibbets P, Stokkel M, Bleeker GB, Ypenburg C, van der Wall EE, Schalij MJ, Garcia EV, Bax JJ. Can LV dyssynchrony as assessed with phase analysis on gated myocardial perfusion SPECT predict response to CRT? J Nucl Med 2007;48:1104-11.CrossRefPubMed Henneman MM, Chen J, Dibbets P, Stokkel M, Bleeker GB, Ypenburg C, van der Wall EE, Schalij MJ, Garcia EV, Bax JJ. Can LV dyssynchrony as assessed with phase analysis on gated myocardial perfusion SPECT predict response to CRT? J Nucl Med 2007;48:1104-11.CrossRefPubMed
21.
go back to reference Friehling M, Chen J, Saba S, Garcia EV, Adelstein E, Martin L, Follansbee WP, Soman P. Feasibility of a novel protocol for serial assessment of left ventricular synchrony by gated SPECT before and after cardiac resynchronization therapy with a single injection of radiotracer (abstract). J Nucl Cardiol 2009;16:675. Friehling M, Chen J, Saba S, Garcia EV, Adelstein E, Martin L, Follansbee WP, Soman P. Feasibility of a novel protocol for serial assessment of left ventricular synchrony by gated SPECT before and after cardiac resynchronization therapy with a single injection of radiotracer (abstract). J Nucl Cardiol 2009;16:675.
22.
go back to reference Trimble MA, Velazquez EJ, Adams GL, Honeycutt EF, Pagnanelli RA, Barnhart HX, Chen J, Iskandrian AE, Garcia EV, Borges-Neto S. Repeatability and reproducibility of phase analysis of gated SPECT myocardial perfusion imaging used to quantify cardiac dyssynchrony. Nucl Med Commun 2008;29:374-81.CrossRefPubMed Trimble MA, Velazquez EJ, Adams GL, Honeycutt EF, Pagnanelli RA, Barnhart HX, Chen J, Iskandrian AE, Garcia EV, Borges-Neto S. Repeatability and reproducibility of phase analysis of gated SPECT myocardial perfusion imaging used to quantify cardiac dyssynchrony. Nucl Med Commun 2008;29:374-81.CrossRefPubMed
Metadata
Title
Repeatability of left ventricular dyssynchrony and function parameters in serial gated myocardial perfusion SPECT studies
Authors
Xianhe Lin, MD, PhD
Huiqin Xu, MD
Xuefeng Zhao, MD
Russell D. Folks, BS, CNMT
Ernest V. Garcia, PhD
Prem Soman, MD, PhD
Ji Chen, PhD
Publication date
01-10-2010
Publisher
Springer-Verlag
Published in
Journal of Nuclear Cardiology / Issue 5/2010
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-010-9238-y

Other articles of this Issue 5/2010

Journal of Nuclear Cardiology 5/2010 Go to the issue