Prognostic value of left ventricular dyssynchrony evaluated by gated myocardial perfusion imaging in patients with chronic kidney disease and normal perfusion defect scores

Mori, Hajime; Isobe, Satoshi; Suzuki, Susumu; Unno, Kazumasa; Morimoto, Ryo; Kano, Naoaki; Okumura, Takahiro; Yasuda, Yoshinari; Katô, Katsuhiko; Murohara, Toyoaki

doi:10.1007/s12350-017-0889-9

Cited by 20 publications

(18 citation statements)

References 30 publications

(30 reference statements)

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“…Mori et al studied LV dyssynchrony in 201 Tl perfusion images of patients with CKD. 8 The incidence of major adverse cardiac events (MACE) was higher The (maximum -minimum)/maximum is 67% (left) and 10% (right), respectively. The original curve has a phase shift of 180°.…”

Section: More Dyssynchrony In Heart Diseasesmentioning

confidence: 96%

“…Lastly, due to dependence on software, values are not interchangeable, but Emory Cardiac Toolbox, QGS, Corridor 4DM, and cardioREPO software could be reliable tools for phase dyssynchrony analysis, 12 as well as Heart Function View. 7,8 Phase analysis is a potentially attractive method of evaluating dyssynchrony. However, the findings of each step of its application cannot be visually supported because they are practically invisible to the naked eye.…”

Section: Are Phase Abnormalities Due To Technology or Pathophysiology?mentioning

confidence: 99%

“…In this issue of the Journal of Nuclear Cardiology, phase analysis was applied to patients with chronic kidney disease (CKD), and increased dyssynchrony was reportedly related to prognosis. 8 Before directly proceeding to clinical applications, we will review technologically confounding factors to understand the real value of phase analysis to clinical studies.…”

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confidence: 99%

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Making the invisible visible: Phase dyssynchrony has potential as a new prognostic marker

Nakajima

Okuda

Matsuo

et al. 2019

Journal of Nuclear Cardiology

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Section: More Dyssynchrony In Heart Diseasesmentioning

confidence: 96%

Section: Are Phase Abnormalities Due To Technology or Pathophysiology?mentioning

confidence: 99%

mentioning

confidence: 99%

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Making the invisible visible: Phase dyssynchrony has potential as a new prognostic marker

Nakajima

Okuda

Matsuo

et al. 2019

Journal of Nuclear Cardiology

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“…In a prospective study, assessing the rate of major adverse cardiac events such as sudden cardiac death, fatal arrhythmias, or acute coronary syndrome requiring revascularization among patients with chronic kidney disease, those with higher phase SD and wider histogram BW had a higher event rate ( P = 0.002). 33 Phase SD was found to be associated with major adverse events (OR 1.33, 95% CI 1.05–1.69, P = 0.01).…”

Section: Evidence Supporting Clinical Use Of Scintigraphic Assessmentmentioning

confidence: 96%

Assessment of dyssynchrony by gated myocardial perfusion imaging does not improve patient management

Lee

Shah

Murthy

2018

Journal of Nuclear Cardiology

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Clinical trials have demonstrated improved outcomes with cardiac resynchronization therapy in patients with heart failure and electrical evidence of dyssynchrony. There has been intense effort at developing imaging markers of dyssynchrony with the aim of improved risk stratification. However, these efforts have not been fruitful to date. This article discusses mechanisms of cardiac dyssynchrony, reviews clinical data supporting resynchronization therapy, and addresses the lack of convincing evidence to support the use of noninvasive imaging measures of dyssynchrony in improving patient management.

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“…Left ventricular dyssynchrony has been investigated in patients with CLBBB 2 and in those with chronic kidney disease and normal perfusion defect scores. 9 Both studies used gated SPECT imaging and phase analysis and found entropy, bandwidth, and phase SD useful. Whether disordered contraction timing within the myocardium has pathophysiological significance that reflects underlying myocardial damage is of interest.…”

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confidence: 99%

What does entropy reveal in phase analysis of myocardial perfusion SPECT?

Okuda

Nakajima

2021

Journal of Nuclear Cardiology

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others expanded the concept into statistical mechanics. Claude Elwood Shannon also introduced a new aspect of entropy into information theory during 1948. 1 Consequently, the long, notable history of entropy studies has facilitated understanding of the laws of nature. Among several equations for entropy that are applied across many scientific disciplines, the Shannon equation (H ¼ À P p i log p i , where p i is the probability of state i) that is based on information theory is applied to phase analyses of gated single-photon emission computed tomography (SPECT). In phase histograms generated from gated SPECT data, p i represents the frequency of the histogram bin i. Entropy increases if the phase distribution becomes disordered in histograms. If the equation for entropy is divided by log (n), in which n represents the number of histogram bins, the entropy range is 0-1, which represents total order to disorder.A study by Shimizu and colleagues published in this issue of the Journal of Nuclear Cardiology showed that entropy and estimated glomerular filtration rates (eGFR) could predict a poor cardiac prognosis in patients with complete left bundle branch block (CLBBB). 2 High entropy and low eGFR were independent predictors determined by Cox regression and Kaplan-Meyer analyses for major cardiac events (MACE) in these patients. Moreover, Random Forest machine learning also clarified entropy and eGFR as independent predictors of MACE. Others have used left ventricular (LV) volumes, LV ejection fraction, echocardiographic parameters, and clinical demographics as predictors of heart disease. Although entropy might be able to clarify the pathophysiology of patients with CLBBB, whether it implies causative indices and provides clinical information that is directly related to pathophysiology cannot be determined. This is because physical aspects of acquisition and processing along with patient-associated factors can influence entropy, which is also susceptible to LV volume, LV ejection fraction, age, statistical noise, and heart failure. 3 Since the phase distribution derived from gated SPECT images can easily be influenced by acquisition conditions and patient characteristics, entropy includes many kinds of artifacts in addition to bandwidth and phase standard deviation (SD). Previous studies have shown that the amount of time required to acquire SPECT images (acquisition time) considerably influences phase analysis. Decreasing acquisition time is associated with increased entropy in clinical patients. 4 Reducing the amount of acquisition time by 50% changed mean entropy from 55.0% ± 6.41% to 59.5% ± 6.06% (p \ 0.002). Moreover, decreased gated SPECT counts were also associated with increased entropy in a phantom study. 5 A decrease in the average SPECT count per pixel from 97.7 to 17.8 increased entropy from 0.26 to 0.35. Acquisition orbits of 180°a nd 360°significantly influenced bandwidth and phase SD in a clinical study. 6 Notably, sex influences phase parameters. 7 When male and female LV end-diastolic volumes were...

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Prognostic value of left ventricular dyssynchrony evaluated by gated myocardial perfusion imaging in patients with chronic kidney disease and normal perfusion defect scores

Abstract: The LV dyssynchrony indices from GMPS may be novel prognostic predictors in CKD patients with normal perfusion defect scores.

Cited by 20 publications

References 30 publications

Making the invisible visible: Phase dyssynchrony has potential as a new prognostic marker

Making the invisible visible: Phase dyssynchrony has potential as a new prognostic marker

Assessment of dyssynchrony by gated myocardial perfusion imaging does not improve patient management

What does entropy reveal in phase analysis of myocardial perfusion SPECT?

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