Assessment of Left Ventricular Systolic and Diastolic Function Using ECG-Gated Technetium-99m Tetrofosmin Myocardial Perfusion SPECT

Abstract

SummaryBecause left ventricular (LV) diastolic dysfunction is frequently the earliest indicator of LV dysfunction in patients with heart failure, the estimation of LV diastolic function is very important. On the other hand, electrocardiography (ECG)-gated technetium (Tc) -99m tetrofosmin single-photon emission computed tomography (SPECT) has been reported to be a useful method for evaluation of LV function. The objective of this study was to examine the usefulness of ECG-gated Tc-99m tetrofosmin SPECT in terms of estimation of cardiac diastolic function. Consecutive 145 patients underwent an ECG-gated Tc-99m tetrofosmin SPECT to estimate systolic and diastolic LV function, and were compared with those evaluated by ultrasound echocardiography (UCG). LV end-diastolic volume, LV end-systolic volume, and LV ejection fraction values obtained by quantitative gated SPECT (QGS) showed significant positive linear correlations with those obtained by UCG. All 145 patients were classified into 3 groups according to diastolic function estimated by UCG. The first-third mean filling rate (1/3 MFR) and peak filling rate (PFR) that revealed the LV diastolic function of the group B (normal systolic function and mild diastolic dysfunction) patients (1.01 ± 0.35, 1.85 ± 0.57) were both significantly lower than those of the group A (normal systolic and diastolic function) patients (1.43 ± 0.37, 2.43 ± 0.56). The 1/3 MFR and PFR of the group C (moderate ~ severe systolic and diastolic dysfunction) patients (0.47 ± 0.34, 0.92 ± 0.62) were also significantly lower than those of the group A and B patients. QGS may be a useful method for the evaluation of cardiac systolic and diastolic function, especially in patients with normal systolic function and diastolic dysfunction. (Int Heart J 2013; 54: 212-215) Key words: Cardiac function, QGS, First-third mean filling rate, Peak filling rate P revious studies have demonstrated that cardiac systolic (left ventricular (LV) ejection fraction (EF)) and diastolic (mitral inflow velocity pattern and/or mitral deceleration time, and/or pulmonary vein inflow velocity pattern) functions evaluated by ultrasound echocardiography (UCG) were predictors of the clinical outcome.1,2) On the other hand, previous studies have also demonstrated that approximately 50% of patients with heart failure present with a normal LV systolic function.3) LV diastolic dysfunction is frequently the earliest indicator of LV dysfunction in patients with heart failure. Therefore, the estimation of LV diastolic function is very important. Recently, electrocardiography (ECG)-gated technetium (Tc)-99m tetrofosmin single-photon emission computed tomography (SPECT) has been reported to be a useful method for evaluation of LV systolic and diastolic functions. 4,5) The purpose of the present study was, therefore, to examine the usefulness of ECG-gated Tc-99m tetrofosmin SPECT in terms of estimation of cardiac function, especially, LV diastolic function. In order to examine this, we compared cardiac systolic and diastolic functions eva...

The impact of hypertension on diastolic left ventricular function, evaluated by quantitative ECG-gated myocardial perfusion SPECT

“…The mean value for PFR of hypertensive and normotensive patients in current study was higher than the mean value of PFR reported in prior studies for patients with mild diastolic dysfunction and normal study population (14,17). Akincioglu et al (17) assessed the values of diastolic function parameters in 90 patients with normal exercise gated SPECT, and no history of hypertension, diabetes, rest electrocardiogram abnormality, or known cardiac disease, and reported a mean normal value for PFR of 2.62 ± 0.46 EDV/s.…”

“…Mizunobu et al (14) reported similar mean values of 1/3 MFR for patients with mild diastolic dysfunction, and patients with normal diastolic function estimated by ultrasound echocardiography (UCG) (1.01 ± 0.35 EDV/s, and 1.43 ± 0.37 EDV/s respectively). Furthermore, the 1/3 MFR of patients with mild diastolic dysfunction estimated by UCG was significantly lower than that of patients with normal diastolic function.…”

“…The evaluation of LV diastolic function as part of routine echocardiographic testing is recommended by the current guidelines of the American Society of echocardiography and the European Association of cardiovascular imaging (12). Several reports have shown that Electrocardiography (ECG)-gated single-photon emission computed tomography (SPECT) was found to have good correlation with echocardiography for assessment of diastolic and systolic LV function and volumes (13)(14)(15)(16). In clinical practice, ECG-gated SPECT may be a good alternative for patients with limitations for optimal echocardiography visualization (13), and the stability of diastolic function variables estimated by ECG-gated SPECT has been reported recently (17).…”

Phase analysis of gated PET in the evaluation of mechanical ventricular synchrony: A narrative overview

“…Beyond their capabilities to characterize myocardial architecture, perfusion, viability, and function, noninvasive imaging modalities offer the added possibility to dynamically evaluate ventricular motion during the cardiac cycle by means of ECG-gated acquisitions 1,2. Such motion characterization is achieved through sequential target detection, cavity orientation, segmentation preprocessing, and motion analysis resulting in quantitative estimates of ventricular mechanical synchrony 3…”

Evaluation of diastolic function in patients with normal perfusion and type 2 diabetes mellitus with gated single-photon emission computed tomography

“…[3] Radionuclide ventriculography (RNV) has long been used in the evaluation of systolic and diastolic functions of the left ventricle, and studies correlated with echocardiography have confirmed its value. [4] Currently, however, it is used less often and does not provide information about myocardial perfusion. MPS is an ideal method with which to provide diagnostic and prognostic information about myocardial perfusion effectively and at low cost.…”