Comparison of the dyssynchrony parameters recorded with gated SPECT in ischemic cardiomyopathy according to their repeatability at rest and to their ability to detect a synchrony reserve under dobutamine infusion

Legallois, Damien; Marie, Pierre-Yves; Franken, Philippe; Djaballah, W.; Denis, Arnaud; Manrique, Alain

doi:10.1007/s12350-018-01546-2

Cited by 9 publications

(8 citation statements)

References 29 publications

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“…We observed a signi cant decrease in all dyssynchrony parameters, particularly entropy, during stress-test in both groups of patients and controls, similar to some of previously published results [5,42,43].…”

Section: Discussionsupporting

confidence: 91%

Low-dose dobutamine stress gated blood pool SPECT assessment of left ventricular contractile reserve in ischemic cardiomyopathy: a feasibility study

Шипулин

Андреев

Pryakhin

et al. 2022

Eur J Nucl Med Mol Imaging

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Purpose: The purpose of present study was to assess the feasibility of GBPS with low-dose dobutamine (LDD) stress test, performed on a SPECT camera equipped with Cadmium-Zinc-Telluride (CZT) solid state detectors in evaluation of patients with ischemic heart failure (HF).Methods. A total of 52 patients with ischemic cardiomyopathy (ICM) and a control group of 10 patients without obstructive coronary artery lesion underwent GBPS and transthoracic echocardiography (TTE) at rest and during LDD stress test (5, 10, 15 µg/kg/min). The duration of each GBPS step was 5 minutes.Stress-induced changes (∆) in LV ejection fraction (LVEF), peak ejection rate, LV volumes and dyssynchrony (phase histogram standard deviation, phase histogram bandwidth and entropy) obtained with GBPS were estimated.Results. All GBPS indices except end-diastolic volume showed signi cant dynamics during stress test in both groups. 17% of ICM patients, but none from control group, showed a decrease in EF during stress, accompanied by a signi cant increase in entropy. The inter-rater reproducibility was excellent for both rest and stress studies. There was a moderate correlation (r=0.5, p=0.01) between GBPS and TTE, with a mean difference value of -1.7 (95% con dence interval -9.8; 6.4; p=0.06) in ΔLVEF.Conclusion. Low-dose dobutamine stress gated blood pool SPECT performed with high-e ciency CZT-SPECT cameras allow evaluation of stress-induced changes in LV contractility and dyssynchrony in patients with ischemic HF. The high sensitivity of the semiconductor detectors provides an opportunity to perform GBPS with lower acquisition time and a decrease in patient radiation exposure.ClinicalTrials.gov identi er: NCT04508608 (

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Section: Discussionsupporting

confidence: 91%

Low-dose dobutamine stress gated blood pool SPECT assessment of left ventricular contractile reserve in ischemic cardiomyopathy: a feasibility study

Шипулин

Андреев

Pryakhin

et al. 2022

Eur J Nucl Med Mol Imaging

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“…The onset of LV mechanical dyssynchrony is associated with variations in the LV systolic phase caused by myocardial damage in patients with CAD, and the severity of LV mechanical dyssynchrony is known to be the greater in patients demonstrating ischemic cardiac dysfunction with a relatively large infarct size ( 20 , 21 ). Sillanmäki et al reported that LV mechanical dyssynchrony measured with SPECT was strongly associated with LV systolic dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Left Ventricular Dyssynchrony Assessed with Nuclear Cardiology for the Prediction of Major Cardiac Events after Revascularization

et al. 2021

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Objective This retrospective study was aimed at determining whether or not stress phase bandwidth (SPBW), a left ventricular (LV) mechanical dyssynchrony index, predicts major cardiac events (MCEs) and stratifies the risk of those in patients with coronary artery disease (CAD) who undergo revascularization. Methods Patients were followed up to confirm the prognosis for at least one year. The SPBW was calculated by a phase analysis using the Heart Risk View-F software program. The composite endpoint was the onset of MCEs, consisting of cardiac death, non-fatal myocardial infarction, unstable angina pectoris, and severe heart failure requiring hospitalization. Patients The study subjects were 332 patients with CAD who underwent coronary angiography and revascularization after confirming " 5% ischemia detected by rest 201 Tl and stress 99m Tc-tetrofosmin electrocardiogram-gated single-photon emission computed tomography myocardial perfusion imaging. Results During the follow-up, 35 patients experienced MCEs of cardiac death (n=5), non-fatal myocardial infarction (n=3), unstable angina pectoris (n=11), and severe heart failure requiring hospitalization (n=16). A receiver operating characteristics analysis indicated that the optimal cut-off value of the SPBW was 52°for predicting MCEs, and the MCE rate was significantly higher in the patients with an SPBW >52°than in those with an SPBW ! 52°. Results of the multivariate analysis showed the SPBW and estimated glomerular filtration rate to be independent predictors for MCEs. In addition, the cut-off value of the SPBW significantly stratified the risk of MCEs according to the results of the Kaplan-Meier analysis. Conclusion Evaluating the SPBW before revascularization may help predict future MCEs in patients with CAD who intended to undergo treatment.

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“…However, the vast majority of these studies have been performed with vasodilator stress, which is less informative for detecting wall motion abnormalities than stress tests with inotropic agents. Only a few studies have investigated stress-induced changes in MD caused by inotropic stimulation [ 13 , 14 ], including the use of GBPS [ 6 , 13 ]. Nevertheless, there are no data related to the predictive value of stress GBPS-derived LV MD changes and complicated EPOP in patients with ICM.…”

Section: Introductionmentioning

confidence: 99%

The Value of Stress-Gated Blood Pool SPECT in Predicting Early Postoperative Period Complications in Ischemic Cardiomyopathy Patients: Focus on Mechanical Dyssynchrony

Шипулин

Андреев

Kopeva

et al. 2023

JCM

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(1) Objective: The objective of this study was to assess the prognostic value of stress-gated blood pool SPECT (GBPS) estimates in patients with ischemic cardiomyopathy (ICM) in the early postoperative period. (2) Methods: A total of 57 patients (age 59.7 ± 6.6, 47 men) with ICM and LV ejection fraction (30 [27.5; 35]%) were enrolled in the study. Before surgical treatment, all patients underwent GBPS (rest–stress, dobutamine doses of 5/10/15 µg/kg/min). Stress-induced changes in left ventricular (LV) ejection fraction, peak ejection rate, volumes, and mechanical dyssynchrony (phase histogram standard deviation, phase entropy (PE), and phase histogram bandwidth) were estimated. Two-dimensional transthoracic echocardiography was performed baseline. Serum levels of NT-proBNP were analyzed with enzyme-linked immunoassay. (3) Results: After surgical treatment, patients were divided into two groups, one, with death, the need for an intra-aortic balloon pump (IABP) or/and inotropic support with a stay in the intensive care unit for more than two days and two, without complications in the early postoperative period (EPOP). Complicated EPOP (CEPOP) was observed in 17 (30%) patients (death—2, IABP—4, extra inotropic support in intensive care unit—11), and 40 patients had no complications (NCEPOP). GBPS showed differences in LV EDV (mL) (321 [268; 358] vs. 268 [242; 313], p = 0.02), LV ESV (mL) (242 [201; 282] vs. 196 [170; 230], p = 0.005), and stress-induced changes in PE (1 (−2; 3) vs. −2 (−4; 0), p = 0.02). Aortic cross-clamp time and stress-induced changes in PE between rest and dobutamine dose of 10 µg/kg/min were the only independent predictors of CEPOP. An increase in LV entropy ≥ 1 on the dobutamine dose of 10µg/kg/min in comparison to rest investigation showed AUC = 0.853 (sensitivity = 62%, specificity = 90%, PPV = 71%; NPV = 85%; p < 0.0001). Conclusion: Stress-induced changes in PE obtained during low-dose dobutamine GBPS are associated with a complicated course of the early postoperative period after surgical treatment for ICM.

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Comparison of the dyssynchrony parameters recorded with gated SPECT in ischemic cardiomyopathy according to their repeatability at rest and to their ability to detect a synchrony reserve under dobutamine infusion

Cited by 9 publications

References 29 publications

Low-dose dobutamine stress gated blood pool SPECT assessment of left ventricular contractile reserve in ischemic cardiomyopathy: a feasibility study

Low-dose dobutamine stress gated blood pool SPECT assessment of left ventricular contractile reserve in ischemic cardiomyopathy: a feasibility study

Prognostic Significance of Left Ventricular Dyssynchrony Assessed with Nuclear Cardiology for the Prediction of Major Cardiac Events after Revascularization

The Value of Stress-Gated Blood Pool SPECT in Predicting Early Postoperative Period Complications in Ischemic Cardiomyopathy Patients: Focus on Mechanical Dyssynchrony

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