Phase Analysis of Gated Myocardial Perfusion Single-Photon Emission Computed Tomography Compared With Tissue Doppler Imaging for the Assessment of Left Ventricular Dyssynchrony

Henneman, Maureen M.; Chen, Ji; Ypenburg, Claudia; Dibbets, Pauline; Bleeker, Gabe B.; Boersma, Eric; Stokkel, Marcel P. M.; Wall, Ernst E. van der; Garcia, Ernest; Bax, Jeroen J.

doi:10.1016/j.jacc.2007.01.063

Cited by 196 publications

(147 citation statements)

References 22 publications

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“…Clinical validation of the technique began by demonstrating that differences in the phase analysis indices exist between patients with left ventricular dysfunction or conduction disturbances and normal controls [15]. Additionally, phase indices were shown to correlate with dyssynchrony as determined by tissue Doppler echocardiography [16]. Our study sought to further the validation of this technique by describing the effect of variability in image processing and reconstruction on phase analysis (repeatability), by describing the optimal image processing method to improve repeatability, and by describing intraobserver and interobserver reproducibility of phase analysis.…”

Section: Discussionmentioning

confidence: 99%

“…A novel method for describing left ventricular mechanical dyssynchrony has been developed, which uses phase analysis of ECG-gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging to describe the timing of the regional left ventricular onset of mechanical contraction (OMC) [14][15][16]. The repeatability and reproducibility of this technique are not known.…”

Section: Introductionmentioning

confidence: 99%

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Repeatability and reproducibility of phase analysis of gated single-photon emission computed tomography myocardial perfusion imaging used to quantify cardiac dyssynchrony

Trimble¹,

Velázquez²,

Adams³

et al. 2008

Nuclear Medicine Communications

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136

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Repeatability and reproducibility of phase analysis of gated single-photon emission computed tomography myocardial perfusion imaging used to quantify cardiac dyssynchrony

Trimble¹,

Velázquez²,

Adams³

et al. 2008

Nuclear Medicine Communications

Self Cite

136

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show abstract

“…These indices are derived retrospectively from prior acquired and saved images, with no additional radiation burden or cost. They are automated, reproducible with small inter and intra-observer variability, 8 repeatable, 9 and have been validated against two 10 and three-dimensional echocardiography. 11 The initial application of the technique was in identifying the optimal patients with cardiomyopathy who would derive most benefit from cardiac resynchronization therapy.…”

Section: See Related Article Pp 1048-1056mentioning

confidence: 99%

Early post-stress LV dyssynchrony: A new marker for significant CAD

AlJaroudi

2014

Journal of Nuclear Cardiology

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Single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) remains one of the most commonly ordered tests for the detection of ischemia and significant coronary artery disease (CAD). 1 A coronary artery territory perfused by a significantly narrowed vessel has limited coronary flow reserve; hence, during peak stress, there are less blood flow and tracer uptake in that region as compared to normal myocardial. The detection of reversible perfusion defect, therefore, depends on the relative flow between myocardial territories. 2 In patients with multivessel disease, the coronary flow reserve is reduced in all territories leading to what has been described as balanced ischemia phenomenon. 3 The latter poses a challenge as patients with multi-vessel CAD may have ''normal'' MPI and could be miss-diagnosed or more commonly assumed to have less extensive CAD. 3 However, other complementary tools have helped recognize the presence of high ischemic burden even when the perfusion images say otherwise. Among them, transient ischemic dilation (TID), 4 increased lung uptake of 5 and left ventricular (LV) stunning (i.e., decrease in early post-stress LV ejection fraction [EF]). These tools, nevertheless, have limitations: the diagnostic accuracy of TID is low; Tl-201 is rarely used and has been replaced by Tc-99m; and LV stunning is often missed or underestimated since imaging with SPECT does not occur at peak stress giving enough time for LV recovery. 6 LV mechanical dyssynchrony indices have been proposed as additional tools to help detect myocardial stunning and ischemia-induced dyssynchronous contraction. The technique was developed by Chen 7 almost a decade ago. It calculates a phase value for each of sampled regions ([600) that represent the onset of mechanical contraction. The standard deviation (phase SD) and 95% bandwidth (histogram bandwidth) represent the LV dyssynchrony indices: the bigger the numbers, the greater the dyssychrony. These indices are derived retrospectively from prior acquired and saved images, with no additional radiation burden or cost. They are automated, reproducible with small inter and intra-observer variability, 8 repeatable, 9 and have been validated against two 10 and three-dimensional echocardiography. 11 The initial application of the technique was in identifying the optimal patients with cardiomyopathy who would derive most benefit from cardiac resynchronization therapy. 12 Since then, the technique proved not only to be a valuable tool in detecting mechanical dyssynchrony, but also providing prognostic information and risk stratifying patients with various co-morbidities (ischemic, 13 non-ischemic cardiomyopathy, 14 implantable defibrillators, 15 end-stage renal disease 16,17 ). More recently, the technique has been used to detect ischemiainduced myocardial dyssynchrony and multi-vessel CAD by comparing stress and rest indices [18][19][20] (Table 1).The concept of stress-induced changes in LV dyssynchrony is not new. In patients with normal MPI undergoing gated...

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“…In fact, phase analysis from nuclear myocardial perfusion imaging has recently gained wide interest as a potential alternative to assess dyssynchrony. 13,14 In the current issue of the Journal, Valzania et al investigated in a prospective manner the effects of CRT on RV function and plasma NT-pro-BNP levels in 36 consecutive patients with non-ischemic dilated cardiomyopathy at baseline with CRT switched off, 10 minutes after CRT activation and 3 months later. In contrast to previous studies, RV function and inter-as well as intraventricular dyssynchrony were assessed by Tc 99m radionuclide angiography.…”

mentioning

confidence: 99%

Cardiac resynchronization therapy in chronic heart failure: Effect on right ventricular function

Benz

Pazhenkottil

2019

Journal of Nuclear Cardiology

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Phase Analysis of Gated Myocardial Perfusion Single-Photon Emission Computed Tomography Compared With Tissue Doppler Imaging for the Assessment of Left Ventricular Dyssynchrony

Cited by 196 publications

References 22 publications

Repeatability and reproducibility of phase analysis of gated single-photon emission computed tomography myocardial perfusion imaging used to quantify cardiac dyssynchrony

Repeatability and reproducibility of phase analysis of gated single-photon emission computed tomography myocardial perfusion imaging used to quantify cardiac dyssynchrony

Early post-stress LV dyssynchrony: A new marker for significant CAD

Cardiac resynchronization therapy in chronic heart failure: Effect on right ventricular function

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