Document Detail

Relation of left-ventricular dyssynchrony by phase analysis of gated SPECT images and cardiovascular events in patients with implantable cardiac defibrillators.
MedLine Citation:
PMID:  20300907     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Left-ventricular (LV) dyssynchrony could be measured by gated SPECT myocardial perfusion imaging (MPI). This study examined the relation between the degree of dyssynchrony and outcome in patients with implantable cardiac defibrillators (ICDs). METHODS AND RESULTS: We studied 70 patients with ICD and LV ejection fraction (EF) <.40 by gated MPI (performed within 6 weeks of the device implantation). The images were re-processed using phase analysis to derive phase standard deviation (SD) and histogram bandwidth. All-cause mortality and appropriate ICD shocks were identified as the primary endpoint. There were 87% men, aged 62 +/- 11 years. The EF was 26 +/- 8% (range 12%-39%). The phase SD was 51 degrees +/- 20 degrees (range 12 degrees -99 degrees ) and the histogram bandwidth was 157 degrees +/- 72 degrees (range 21 degrees -327 degrees ). The SD and bandwidth were significantly greater than corresponding values in patients with normal EF (15.8 +/- 11.8 degrees and 42.0 +/- 28.4 degrees , respectively, P < .0001, each). At 1 year, 8 patients (11%) died or had shocks. The patients with events had higher phase SD than those without events (60 +/- 5 degrees vs 50 +/- 21 degrees , P = .002). The histogram bandwidth was also higher in those with events (185 +/- 37 vs 154 +/- 75, P = .07). All patients with event had a phase SD >or= 50 degrees , while none of the patients with a phase SD < 50 degrees (N = 26) had an event (P = .02). CONCLUSIONS: The severity of LV dyssynchrony by phase analysis in patients with LV dysfunction, and ICD is associated with increased risk of death and appropriate ICD shock; a phase SD < 50 degrees was associated with no events at 1 year.
Wael A Aljaroudi; Fadi G Hage; Daniel Hermann; Harish Doppalapudi; Rajesh Venkataraman; Jaekyeong Heo; Ami E Iskandrian
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Publication Detail:
Type:  Journal Article     Date:  2010-03-19
Journal Detail:
Title:  Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology     Volume:  17     ISSN:  1532-6551     ISO Abbreviation:  J Nucl Cardiol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-11     Completed Date:  2010-08-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423534     Medline TA:  J Nucl Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  398-404     Citation Subset:  IM    
Division of Cardiovascular Diseases, Department of Medicine, University of Alabama at Birmingham, 318 LHRB, 1900 University BLVD, Birmingham, AL 35294-0006, USA.
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MeSH Terms
Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography*
Defibrillators, Implantable*
Middle Aged
Myocardial Perfusion Imaging*
Ventricular Dysfunction, Left / radionuclide imaging,  therapy*
Comment In:
J Nucl Cardiol. 2010 Jun;17(3):354-8   [PMID:  20387136 ]

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