| Use of phase analysis of gated SPECT perfusion imaging to quantify dyssynchrony in patients with mild-to-moderate left ventricular dysfunction. | |
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MedLine Citation:
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PMID: 19690935 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: CRT has been shown to be beneficial in the majority of patients with NYHA class III-IV symptoms, prolonged QRS duration, and an EF < or =35%. The use of imaging modalities to quantify dyssynchrony may help identify patients who may benefit from CRT, but do not meet current selection criteria. We hypothesize that patients with mild-to-moderate LV dysfunction have significant degrees of mechanical dyssynchrony. METHODS: We compared phase analysis measures of mechanical dyssynchrony from gated SPECT imaging in patients with mild-to-moderate LV dysfunction (EF 35-50%, n = 93), with patients with severe LV dysfunction (EF < or = 35%, n = 167), and with normal controls (EF > or = 55%, n = 75). Furthermore, we evaluated the relationships between QRS duration and dyssynchrony and determined the prevalence of dyssynchrony in patients with mild-moderate LV dysfunction. RESULTS: Patients with mild-moderate LV dysfunction have more dyssynchrony than normal controls (phase SD 37.7 degrees vs 8.8 degrees , P < .001 and bandwidth 113.5 degrees vs 28.7 degrees , P < .001), but less dyssynchrony than patients with severe LV dysfunction (phase SD 37.7 degrees vs 52.0 degrees , P < .001 and bandwidth 113.5 degrees vs 158.2 degrees , P < .001). In the cohort of patients with LV EF 35-50%, there were only weak correlations between QRS duration and dyssynchrony (phase SD, r = 0.28 and bandwidth, r = 0.20). There were 73 patients with LVEF 35-50% and QRS duration <120 milliseconds of which 21 (28.8%) had mechanical dyssynchrony. Overall, 37% of patients with mild-to-moderate LV dysfunction had significant degrees of mechanical dyssynchrony. CONCLUSIONS: This is the largest reported study evaluating mechanical dyssynchrony in patients with mild-moderate LV dysfunction using phase analysis of gated SPECT imaging. In this study, approximately one-third of patients with mild-to-moderate LV dysfunction had significant LV mechanical dyssynchrony. With further study, phase analysis of gated SPECT imaging may help improve patient selection for CRT. |
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Authors:
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Allen E Atchley; Mark A Trimble; Zainab Samad; Linda K Shaw; Robert Pagnanelli; Ji Chen; Ernest V Garcia; Ami E Iskandrian; Eric J Velazquez; Salvador Borges-Neto |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2009-08-19 |
Journal Detail:
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Title: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology Volume: 16 ISSN: 1532-6551 ISO Abbreviation: J Nucl Cardiol Publication Date: 2009 Nov-Dec |
Date Detail:
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Created Date: 2009-11-12 Completed Date: 2010-02-02 Revised Date: 2011-09-26 |
Medline Journal Info:
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Nlm Unique ID: 9423534 Medline TA: J Nucl Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 888-94 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Duke University Medical Center, Durham, NC, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Algorithms* Female Gated Blood-Pool Imaging / methods* Humans Image Enhancement / methods Image Interpretation, Computer-Assisted / methods* Male Middle Aged Myocardial Perfusion Imaging / methods* Reproducibility of Results Sensitivity and Specificity Tomography, Emission-Computed, Single-Photon / methods* Ventricular Dysfunction, Left / radionuclide imaging* |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL094438-02/HL/NHLBI NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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