The Prognostic Value of Diastolic and Systolic Mechanical Left Ventricular Dyssynchrony Among Patients With Coronary Heart Disease

Fudim, Marat; Fathallah, Mouhammad; Shaw, Linda K.; Liu, Peter R.; James, Olga; Samad, Zainab; Piccini, Jonathan P.; Hess, Paul L.; Borges‐Neto, Salvador

doi:10.1016/j.jcmg.2018.05.018

Cited by 37 publications

(20 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Beyond the LVEF, delayed times of contraction and dyssynchrony are important independent signs of LV dysfunction . The assessment of myocardial deformation, such as the strain and strain rate, through the tissue Doppler or global longitudinal strain (GLS) or on gated single‐photon emission computed tomography myocardial perfusion imaging could be alternative methods to classify HF patients . The GLS is measured on the basis of the LV longitudinal shortening in systole, and it is an index of systolic function .…”

Section: Left Ventricular Ejection Fraction Based Classification: Opportunities and Limitationsmentioning

confidence: 99%

Heart failure with mid‐range ejection fraction: pro and cons of the new classification of Heart Failure by European Society of Cardiology guidelines

et al. 2020

Self Cite

View full text Add to dashboard Cite

Currently, the assessment of left ventricular ejection fraction (LVEF) is the cornerstone of the classification of patients with heart failure (HF). The mid-range LVEF (HFmrEF) category was identified in an attempt to uncover specific characteristics of these patients. So far, the analysis of trials, registries, and observational studies have demonstrated that patients with midrange LVEF belong to a patient cohort with generally intermediate clinical profile as compared with other groups but with a remarkable variety of intrinsic phenotypes. This is due to the limitations of LVEF as the sole criterion to categorize patients with HF and characterize their prognosis, above all when it is >40%. To better define the HFmrEF phenotype, it is reasonable to consider other parameters, such as LVEF changes over time, HF aetiology, co-morbidities, and other imaging parameters. A multiparametric evaluation may contextualize a patient with HFmrEF in a more defined phenotype with a specific prognosis.

show abstract

Section: Left Ventricular Ejection Fraction Based Classification: Opportunities and Limitationsmentioning

confidence: 99%

Heart failure with mid‐range ejection fraction: pro and cons of the new classification of Heart Failure by European Society of Cardiology guidelines

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…Further, diastolic LVMD was associated with all-cause and cardiovascular mortality independent of LVEF. 16 Finally, the few studies that evaluated the prognostic significance of diastolic LVMD via GSPECT MPI suggested a greater value of diastolic over systolic LVMD in selecting CRT candidates among HF patients. 17 The analysis by Alexanderson-Rosas et al assessed the utility of diastolic LVMD measured by GSPECT MPI in patients with HFrEF who underwent CRT.…”

mentioning

confidence: 99%

Utility of diastolic dyssynchrony in the setting of cardiac resynchronization therapy

Fudim

Borges‐Neto

2021

Journal of Nuclear Cardiology

Self Cite

View full text Add to dashboard Cite

“…To date, the pathophysiology and clinical value of diastolic LVMD had not been studied extensively. Similar to systolic LVMD, diastolic LVMD could assess the phase and amplitude of regional myocardial relaxation by multiple Fourier transforms to quantify myocardial discoordination in diastole ( 23) and appears to provide incremental value in the prediction of adverse outcomes (28). In our study, both systolic and diastolic LVMD were included and it was suggested that diastolic LVMD was more strongly associated with myocardial viability, as seen in the diastolic phase histogram.…”

Section: Discussionmentioning

confidence: 92%

Incremental Value of Left Ventricular Mechanical Dyssynchrony Assessment by Nitrogen-13 Ammonia ECG-Gated PET in Patients With Coronary Artery Disease

Zheng

Liu

Zhang

et al. 2021

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Background: Phase analysis is a technique used to assess left ventricular mechanical dyssynchrony (LVMD) in nuclear myocardial imaging. Previous studies have found an association between LVMD and myocardial ischemia. We aim to assess the potential diagnostic value of LVMD in terms of myocardial viability, and ability to predict major adverse cardiac events (MACE), using Nitrogen-13 ammonia ECG-gated positron emission tomography (gPET).Methods: Patients with coronary artery disease (CAD) who underwent Nitrogen-13 ammonia and Fluorine-18 FDG myocardial gPET were enrolled, and their gPET imaging data were retrospectively analyzed. Patients were followed up and major adverse cardiac events (MACE) were recorded. The Kruskal-Wallis test and Mann-Whitney U test were performed to compare LVMD parameters among the groups. Binary logistic regression analysis, receiver operating characteristic (ROC) curve analysis, and multiple stepwise analysis curves were applied to identify the relationship between LVMD parameters and myocardial viability. Kaplan–Meier survival curves and the log-rank test were used to look for differences in the incidence of MACE.Results: In total, 79 patients were enrolled and divided into three groups: Group 1 (patients with only viable myocardium, n = 7), Group 2 (patients with more viable myocardium than scar, n = 33), and Group 3 (patients with less viable myocardium than scar, n = 39). All LVMD parameters were significantly different among groups. The median values of systolic phase standard deviation (PSD), systolic phase histogram bandwidth (PHB), diastolic PSD, and diastolic PHB between Group 1 and Group 3, and Group 2 and Group 3 were significantly different. A diastolic PHB of 204.5° was the best cut-off value to predict the presence of myocardial scar. In multiple stepwise analysis models, diastolic PSD, ischemic extent, and New York Heart Association (NYHA) classification were independent predictive factors of viable myocardium and myocardial scar. The incidence of MACE in patients with diastolic PHB > 204.5° was 25.0%, higher than patients with diastolic PHB <204.5° (11.8%), but the difference was not significant.Conclusions: LVMD generated from Nitrogen-13 ammonia ECG-gated myocardial perfusion imaging had added diagnostic value for myocardial viability assessment in CAD patients. LVMD did not show a definite prognostic value.

show abstract

The Prognostic Value of Diastolic and Systolic Mechanical Left Ventricular Dyssynchrony Among Patients With Coronary Heart Disease

Abstract: Systolic and diastolic left ventricular dyssynchrony, as measured by using GSPECT MPI, were associated with adverse outcomes. Moreover, diastolic dyssynchrony appears to provide incremental predictive value to clinical history, electrical dyssynchrony, and left ventricular function.

Cited by 37 publications

References 32 publications

Heart failure with mid‐range ejection fraction: pro and cons of the new classification of Heart Failure by European Society of Cardiology guidelines

Heart failure with mid‐range ejection fraction: pro and cons of the new classification of Heart Failure by European Society of Cardiology guidelines

Utility of diastolic dyssynchrony in the setting of cardiac resynchronization therapy

Incremental Value of Left Ventricular Mechanical Dyssynchrony Assessment by Nitrogen-13 Ammonia ECG-Gated PET in Patients With Coronary Artery Disease

Contact Info

Product

Resources

About