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01-08-2020 | Cardiomyopathy | ORIGINAL ARTICLE

Could myocardial viability be related to left ventricular dyssynchrony? Simultaneous evaluation by gated SPECT-MPI

Authors: Kenia Padrón, MD, Amalia Peix, MD, PhD, Lázaro Cabrera, MD, José Garcia, MD, Lydia Rodriguez, BSc, Regla Carrillo, BSc, Erick Mena, BSc, Yoel Fernandez, BSc

Published in: Journal of Nuclear Cardiology | Issue 4/2020

Abstract

Background

Left ventricular contraction dyssynchrony (LVCD) has been related to induced ischemia and transmural scar but the interplay of myocardial viability and dyssynchrony is unknown. The aim of the present study was to establish the role of dyssynchrony in the context of a viability study performed with nitrate augmentation gated single photon emission computed tomography (GSPECT) myocardial perfusion imaging (MPI).

Methods

Fifty-four consecutive patients with ischemic dilated cardiomyopathy (IDC) and depressed left ventricular ejection fraction (LVEF) were included. They underwent a two-day rest/nitroglycerine (NTG) study GSPECT MPI to determine the myocardial viability. Patients with a nitrate-induced uptake increase of > 10% vs baseline, in at least, two consecutive dysfunctional segments were considered viable as well as those who showed no improvement in the uptake but the uptake was > 50% on post NTG study. Patients with no nitrate-induced uptake increase of > 10% and the uptake of < 50% were considered non-viable. Perfusion, function and LVCD were compared in 25 viable patients vs 29 non-viable patients at baseline and after NTG administration.

Results

After NTG administration, in the viable group, the LVEF increased (36.44 ± 6.64% vs 39.84 ± 6.39%) and the end-systolic volume decreased significantly (119.28 ± 31.77 mL vs 109.08 ± 33.17 mL) (P < 0.01). These patients also experienced a significant reduction in the LVCD variables: phase standard deviation was reduced in the post NTG study (57.77° ± 19.47° vs 52.02° ± 17.09°) as well as the phase histogram bandwidth (190.20° ± 78.83° vs 178.0° ± 76.14°) (P < 0.05). Functional and LVCD variables remained similar in the non-viable patients (P > 0.05).

Conclusion

In patients with IDC and depressed LVEF, the myocardial viability detected by rest/ NTG GSPECT MPI, might determine LVCD improvement.

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Title: Could myocardial viability be related to left ventricular dyssynchrony? Simultaneous evaluation by gated SPECT-MPI
Authors: Kenia Padrón, MD
Amalia Peix, MD, PhD
Lázaro Cabrera, MD
José Garcia, MD
Lydia Rodriguez, BSc
Regla Carrillo, BSc
Erick Mena, BSc
Yoel Fernandez, BSc
Publication date: 01-08-2020
Publisher: Springer International Publishing
Keywords: Cardiomyopathy
Nitrate
Nitroglycerin
Published in: Journal of Nuclear Cardiology / Issue 4/2020
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI: https://doi.org/10.1007/s12350-020-02047-x

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