Reference values for left ventricular systolic synchrony according to phase analysis of ECG-gated myocardial perfusion SPECT

Clin Physiol Funct Imaging. 2018 Jan;38(1):38-45. doi: 10.1111/cpf.12379. Epub 2016 Jul 24.

Abstract

Background: The aim of this study was to define reference values for left ventricular systolic synchrony and for the volume parameters of the left ventricle using myocardial perfusion SPECT-derived phase analysis method.

Methods: We evaluated data of 433 patients who underwent myocardial perfusion SPECT/CT during January 2012-February 2013 in Kuopio University Hospital. The final study population consisted of 52 patients (aged 42-84 years) who met the criteria: (1) no previously diagnosed cardiac disease, (2) normal ECG at rest, (3) no advanced coronary artery disease in CT and 4) normal myocardial perfusion in stress/rest myocardial perfusion SPECT/CT. The severity of mechanical dyssynchrony was assessed by phase analysis of gated myocardial SPECT at stress stage after pharmacological exercise and at rest using Quantitative Gated SPECT (QGS) software. Volume parameters of the left ventricle were also assessed.

Results: The phase histogram bandwidth at rest was 28.0 [63.7] degrees (median [95th percentile]). The standard deviation of phase histogram at rest was 7.8 [26.5] degrees. Entropy at the rest study was 54.0 [63.7] %. All left ventricular dyssynchrony parameters were statistically significantly higher at stress compared to rest. There were no statistically significant differences in dyssynchrony values between men and women. In volume parameters, reference values in male were expectedly higher than in female. Cardiac output did not differ significantly between genders.

Conclusion: In subjects without signs of cardiac diseases, the left ventricular systolic function is well synchronized. Phase analysis measurement does not depend on gender, age, BMI or blood pressure, but the values of dyssynchrony parameters increase during pharmacological stress.

Keywords: 99mTc-tetrofosmin; ECG; QGS software; gated SPECT; heart failure; left ventricular dyssynchrony; phase analysis.

MeSH terms

  • Adenosine / administration & dosage
  • Adult
  • Aged
  • Aged, 80 and over
  • Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / methods
  • Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / standards*
  • Electrocardiography / standards*
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted
  • Male
  • Middle Aged
  • Myocardial Perfusion Imaging / methods
  • Myocardial Perfusion Imaging / standards*
  • Organophosphorus Compounds / administration & dosage
  • Organotechnetium Compounds / administration & dosage
  • Predictive Value of Tests
  • Radiopharmaceuticals / administration & dosage
  • Reference Values
  • Reproducibility of Results
  • Retrospective Studies
  • Severity of Illness Index
  • Single Photon Emission Computed Tomography Computed Tomography / standards*
  • Software
  • Systole
  • Vasodilator Agents / administration & dosage
  • Ventricular Dysfunction, Left / diagnostic imaging*
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Function, Left*

Substances

  • Organophosphorus Compounds
  • Organotechnetium Compounds
  • Radiopharmaceuticals
  • Vasodilator Agents
  • technetium tc-99m tetrofosmin
  • Adenosine