The effects of dobutamine stress on cardiac mechanical synchrony determined by phase analysis of gated SPECT myocardial perfusion imaging in a canine model

Salimian, Samaneh; Thibault, Bernard; Finnerty, Vincent; Grégoire, Jean; Harel, François

doi:10.1007/s12350-013-9847-3

Cited by 10 publications

(6 citation statements)

References 27 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 robustness and sensitivity of entropy in specifying the dyssynchrony variations during the stress SPECT have been reported previously even in healthy canine subjects. 19,20 In this study, entropy (P = 0.04) and BW (P = 0.049) indicated a significant contraction synchrony improvement under stress condition in patients with ischemia and depressed ejection fraction. Low-dose dobutamine might enforce higher coordination in regional mechanical contraction in these patients.…”

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confidence: 49%

Left ventricular mechanical dyssynchrony under stress: Isn’t it time to conduct a prospective multicenter study?

Salimian

2020

Journal of Nuclear Cardiology

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“…Only a few investigations acquired SPECT data directly during the stress test [ 6 , 39 , 40 ]. In the experimental study by Salimian S. et al [ 40 ] on the canine model, all SPECT-MPI-derived dyssynchrony parameters demonstrated a falling trend with an increase in the dobutamine level (suggesting more synchronous mechanical activation during stress). These results were later confirmed in the clinical study based on ICM patients [ 14 ].…”

Section: Discussionmentioning

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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The effects of dobutamine stress on cardiac mechanical synchrony determined by phase analysis of gated SPECT myocardial perfusion imaging in a canine model

Abstract: Dobutamine stimulation could amplify the ventricular synchronism, and the thickening-based approach is more accurate than wall displacement for assessment of mechanical dyssynchrony in GMPS.

Cited by 10 publications

References 27 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

Left ventricular mechanical dyssynchrony under stress: Isn’t it time to conduct a prospective multicenter study?

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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