Longitudinal evaluation of diastolic dyssynchrony by SPECT gated myocardial perfusion imaging early after acute myocardial infarction and the relationship with left ventricular remodeling progression in a swine model

Feifei Zhang; Jianfeng Wang; Xiaoliang Shao; Min Xu; Yongjun Chen; Shengdeng Fan; Yunmei Shi; Bao Liu; Wenji Yu; Xiaoxia Li; Mei Xu; Minfu Yang; Xiaoying Xi; Zhifang Wu; Sijin Li; Yuetao Wang

doi:10.1007/s12350-020-02483-9

Longitudinal evaluation of diastolic dyssynchrony by SPECT gated myocardial perfusion imaging early after acute myocardial infarction and the relationship with left ventricular remodeling progression in a swine model

J Nucl Cardiol. 2022 Aug;29(4):1520-1533. doi: 10.1007/s12350-020-02483-9. Epub 2021 Jan 27.

Authors

Feifei Zhang^{1

2}, Jianfeng Wang^{1

2}, Xiaoliang Shao^{1

2}, Min Xu³, Yongjun Chen⁴, Shengdeng Fan⁵, Yunmei Shi^{1

2}, Bao Liu^{1

2}, Wenji Yu^{1

2}, Xiaoxia Li^{1

2}, Mei Xu^{1

2}, Minfu Yang⁶, Xiaoying Xi⁶, Zhifang Wu⁷, Sijin Li⁷, Yuetao Wang^{8

9}

Affiliations

¹ Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No. 185, Juqian Street, Changzhou, 213003, Jiangsu Province, China.
² Changzhou Key Laboratory of Molecular Imaging, Changzhou, Jiangsu Province, China.
³ Department of Echocardiogram, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, China.
⁴ Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, China.
⁵ Department of Anesthesiology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, China.
⁶ Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
⁷ Department of Nuclear Medicine, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.
⁸ Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No. 185, Juqian Street, Changzhou, 213003, Jiangsu Province, China. yuetao-w@163.com.
⁹ Changzhou Key Laboratory of Molecular Imaging, Changzhou, Jiangsu Province, China. yuetao-w@163.com.

PMID: 33506381
DOI: 10.1007/s12350-020-02483-9

Abstract

Background: Left ventricular diastolic dyssynchrony (LVDD), a dyssynchronous relaxation pattern, has been known to develop after myocardial damage. We aimed to evaluate the dynamic changes in LVDD in the early stage of acute myocardial infarction (AMI) by phase analysis of ^99mtechnetium methoxyisobutylisonitrile (^99mTc-MIBI) single-photon emission computed tomography (SPECT) gated myocardial perfusion imaging (GMPI) and explore its relationship with the progression of left ventricular remodeling (LVR).

Methods: The left anterior descending coronary arteries of 16 Bama miniature swine were occluded with a balloon to build AMI models. Animals were imaged by SPECT GMPI before AMI and at 1 day, 1 week and 4 weeks after AMI, and quantitative analysis was performed to determine the extent of left ventricle (LV) perfusion defects, left ventricular systolic dyssynchrony (LVSD) and the LVDD parameters: phase histogram bandwidth (PBW) and phase standard deviation (PSD). Echocardiography was simultaneously applied to evaluate left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF), and the LVDD parameters: Te-12-diff and Te-12-SD. Myocardial injury markers were measured, and 12-lead ECGs were performed. The degree of LVR progression was defined as ΔLVESV (%) = (LVESV_AMI4weeks - LVESV_AMI1day)/LVESV_AMI1day.

Results: Thirteen swine completed the study. LVDD parameters changed dynamically at different time points after AMI. LVDD occurred as early as 1 day after AMI, peaked at 1 week, and trended toward a partial recovery at 4 weeks. Phase analysis on SPECT GMPI showed a significant correlation with tissue Doppler imaging for the assessment of LVDD during the longitudinal evaluation (r = 0.569 to 0.787, both P <0.05). During the univariate and multivariate regression analyses, the LVDD parameters PBW and PSD as of 1 day after AMI were significantly associated with the progression of LVR, respectively (PBW, β = 0.004, 95% CI 0.001 to 0.007, P = 0.024; PSD, β = 0.008, 95% CI 0.000 to 0.017, P = 0.049). Adjusted smooth curve fitting and threshold effect analysis indicated PBW and PSD break-point values of 142° and 60.4°, respectively, to predict the progression of LVR after AMI.

Conclusions: Phase analysis of SPECT GMPI can accurately and reliably characterize LVDD. LVDD occurred on the first day after AMI, reached its peak at 1 week, and partially recovered at 4 weeks after AMI. LVDD as evaluated by phase analysis of SPECT GMPI early after AMI was significantly associated with the progression of LVR. The early assessment of LVDD after AMI may provide helpful information for predicting the progression of LVR in the future.

Keywords: Acute myocardial infarction; Diastolic dyssynchrony; Gated; Myocardial perfusion imaging; Phase analysis; Progression; Remodeling.

MeSH terms

Animals
Myocardial Infarction* / complications
Myocardial Perfusion Imaging*
Stroke Volume
Swine
Swine, Miniature
Technetium
Tomography, Emission-Computed, Single-Photon / methods
Ventricular Dysfunction, Left* / complications
Ventricular Dysfunction, Left* / etiology
Ventricular Function, Left
Ventricular Remodeling

Substances

Technetium