scholarly journals The assessment of left ventricular mechanical dyssynchrony from gated 99mTc-tetrofosmin SPECT and gated 18F-FDG PET by QGS: a comparative study

2021 ◽  
Author(s):  
Sebastian Lehner ◽  
Frank Philipp Graner ◽  
Maximilian Fischer ◽  
Harun Ilhan ◽  
Peter Bartenstein ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Roc Analysis ◽  
Mechanical Dyssynchrony ◽  
Left Ventricular ◽  
Reference Ranges ◽  
Reference Standard ◽  
99Mtc Tetrofosmin ◽  
Gated Pet ◽  
Significant Difference ◽  
Left Ventricular Mechanical Dyssynchrony

Abstract Background Due to partly conflicting studies, further research is warranted with the QGS software package, with regard to the performance of gated FDG PET phase analysis as compared to gated MPS as well as the establishment of possible cut-off values for FDG PET to define dyssynchrony. Methods Gated MPS and gated FDG PET datasets of 93 patients were analyzed with the QGS software. BW, Phase SD, and Entropy were calculated and compared between the methods. The performance of gated PET to identify dyssynchrony was measured against SPECT as reference standard. ROC analysis was performed to identify the best discriminator of dyssynchrony and to define cut-off values. Results BW and Phase SD differed significantly between the SPECT and PET. There was no significant difference in Entropy with a high linear correlation between methods. There was only moderate agreement between SPECT and PET to identify dyssynchrony. Entropy was the best single PET parameter to predict dyssynchrony with a cut-off point at 62%. Conclusion Gated MPS and gated FDG PET can assess LVMD. The methods cannot be used interchangeably. Establishing reference ranges and cut-off values is difficult due to the lack of an external gold standard. Further prospective research is necessary.

scholarly journals Comparing Left Ventricular Mechanical Dyssynchrony between Diabetic and Non-Diabetic Patients with Normal Gated SPECT MPI

2021 ◽  
Author(s):  
Elinaz Hosseinzadeh ◽  
Mohammadali Ghodsirad ◽  
Toktam Alirezaei ◽  
Maryam Arefnia ◽  
Elahe Pirayesh ◽  
...  
Keyword(s):  
Phase Analysis ◽  
Gated Spect ◽  
Mechanical Dyssynchrony ◽  
Left Ventricular ◽  
Control Group ◽  
Diabetic Patients ◽  
Spect Mpi ◽  
Significant Difference ◽  
Left Ventricular Mechanical Dyssynchrony

Abstract Introduction; the aim of this study was to employ phase analysis to diagnose left ventricular mechanical dyssynchrony (LVMD)in asymptomatic patients with diabetes mellitus type 2 and normal perfusion study to prevent diabetic cardiomyopathy.Methods & materials; Ninety-three consecutive patients with known type 2 diabetes and 81 age- and gender- matched patients without diabetes who were candidates for SPECT-MPI were considered as the control group. The presence of LVMD as an indicator of cardiomyopathy- was determined using phase analysis for each scan with quantitative gated SPECT (QGS) and corridor4DM (4DM) software. All outcomes such as phase bandwidth (PBW) and phase standard deviation (PSD) were compared between the two groups. Results; A total of 174 patients were included in the study. There were no statistically significant difference regarding demographic factors between the two groups (P>0.05). PBW showed statistically significant differences (increased in diabetics) between the control and diabetic patients (P < 0.05). Kruskal Wallis analysis revealed that as the duration of diabetes is prolonged, especially more than 15 years, the probability of LVMD is increased as well (p=0.021). Discussion; Fraction of asymptomatic diabetic patients with normal ejection fraction and gated SPECT MPI-especially those with prolonged diabetes- might have some degrees of LVMD. Phase analysis can detect this which in turn would prevent progress into heart failure.

scholarly journals The prognostic value of left ventricular mechanical dyssynchrony in predicting incident atrial fibrillation and ischemic stroke in the general population

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Saed Alhakak ◽  
S.R Biering-Sorensen ◽  
R Mogelvang ◽  
G.B Jensen ◽  
P Schnohr ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
General Population ◽  
Mechanical Dyssynchrony ◽  
Left Ventricular ◽  
Composite Outcome ◽  
Prognostic Information ◽  
Left Ventricular Mechanical Dyssynchrony ◽  
Multivariable Adjustment ◽  
Incremental Prognostic Information

Abstract Background Left ventricular mechanical dyssynchrony (LVMD) is a predictor of many cardiovascular outcomes including ventricular arrhythmias. However, the prognostic value of LVMD in predicting incident atrial fibrillation (AF) in participants from the general population is currently unknown. Purpose The aim of this study was to investigate if LVMD can be used to predict AF and ischemic stroke in the general population. Methods A total of 1282 participants (mean age 57±16 years, 42% male) from the general population underwent a health examination including two-dimensional speckle tracking echocardiography. LVMD was calculated as the standard deviation of the regional time-to-peak strain from the three apical views. The primary endpoint was incident AF at follow-up. All participants with known AF and prior stroke at baseline were excluded (n=84). The secondary endpoint consisted of the composite of AF and ischemic stroke. Results During a median follow-up of 16 years, 148 participants (12%) were diagnosed with incident AF and 88 (7%) experienced an ischemic stroke, resulting in 236 (19%) experiencing the composite outcome. The risk of AF increased incrementally with increasing tertile of LVMD, being approximately 2-fold higher in the 3rd tertile as compared to the 1st tertile (HR 1.79; 95% CI (1.22–2.63), p=0.003; figure). LVMD was a univariable predictor of AF with 7% increased risk per 10ms increase in LVMD (per 10ms: HR 1.07; 95% CI (1.03–1.12), p&lt;0.001). The association remained significant even after multivariable adjustment for age, sex, body mass index, hypertension, diabetes, previous ischemic heart disease, systolic blood pressure, diastolic blood pressure, heart rate, smoking, plasma proBNP, left ventricular ejection fraction &lt;50%, global longitudinal strain, left atrial volume index (LAVI) and E/e' (per 10ms increase: HR 1.06; 95% CI (1.01–1.12), p=0.018). LVMD was also a univariable predictor of the composite outcome of AF and ischemic stroke (per 10ms increase: HR 1.07; 95% CI (1.04–1.11), p&lt;0.001). After multivariable adjustment for the same clinical and echocardiographic parameters, LVMD remained an independent predictor of the composite outcome (per 10ms: HR 1.07; 95% CI (1.03–1.11), p=0.001). Additionally, LVMD provided incremental prognostic information with regard to predicting AF as assessed by a significant increase in the net reclassification improvement (NRI) index beyond the CHARGE-AF score (continuous NRI, 0.300; 95% CI, 0.022–0.503). Furthermore, LVMD provided additional incremental prognostic information, when added to both the CHARGE-AF score and the LAVI (continuous NRI, 0.269; 95% CI, 0.004–0.499). Conclusion In a low risk general population, LVMD provides novel prognostic information on the long-term risk of AF and ischemic stroke. In addition, LVMD provides incremental prognostic information beyond the CHARGE-AF score and LAVI in predicting AF in the general population. Funding Acknowledgement Type of funding source: None

scholarly journals Comparison of left ventricle mechanical dyssynchrony parameters in ischemic and non-ischemic patients using 13N-NH3 PET/CT

2021 ◽  
Author(s):  
Angelica Mazzoletti ◽  
Domenico Albano ◽  
Francesco Bertagna ◽  
Claudio Tinoco Mesquita ◽  
Raffaele Giubbini
Keyword(s):  
Myocardial Necrosis ◽  
Mechanical Dyssynchrony ◽  
Left Ventricular ◽  
Ischemic Group ◽  
Pet Ct ◽  
Left Ventricular Mechanical Dyssynchrony ◽  
Perfusion Defects ◽  
Induced Changes ◽  
The Relationship ◽  
Post Stress

Abstract Background-Aim The relationship between perfusion pattern and stress-induced changes in Left Ventricular Mechanical Dyssynchrony (LVMD) has been previously described with controversial results using stress-rest perfusion imaging studies. The aim of this study was to assess the relationship between perfusion pattern and stress-induced changes in LVMD usingo regadenoson/rest13N-NH3 PET/CT. Methods There were 74 patients who underwent stress-rest 13N-NH PET/CT from January 2014 to October 2018 excluding patients with left bundle branch block, ventricular pacing and myocardial necrosis. The patients were divided into those with reversible perfusion defects at stress (Ischemic group, n = 18) and patients without reversible perfusion defects (non-ischemic group, n = 56). The LVMD parameters included: phase standard deviation (PSD) and phase histogram bandwidth (PHB), after stress and at rest. The ΔPSD (post-stressPSD-restPSD) and ΔPHB (post-stressPHB—restPHB) were calculated to measure stress-induced changes in LVMD. Results There were no significant differences in LVMD parameters between post-stress and at rest in both groups. The PSD post-stress, ΔPSD and PHB post-stress were significantly higher in the ischemic group. Conclusions Using a vasodilator as a stress, the PSD and PHB post-stress and ΔPSD were significantly higher in the ischemic patients than the non-ischemic group, while there were no significant differences in each cohort between stress and rest indices.

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