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Clinical values of left ventricular mechanical dyssynchrony assessment by gated myocardial perfusion SPECT in patients with acute myocardial infarction and multivessel disease

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Abstract

Purpose

The aim of this study was to evaluate the prognostic value of additional evaluation of left ventricular mechanical dyssynchrony (LVMD) by gated myocardial perfusion single-photon emission computed tomography (GMPS) in patients with acute myocardial infarction (MI) and multivessel disease.

Methods

One hundred and nine acute MI patients with >50 % stenosis in at least one non-culprit artery who underwent GMPS within 2 weeks were enrolled. All patients underwent successful revascularization of the culprit arteries. Those with previous MI, atrial fibrillation, or frequent ventricular premature complexes, cardiac devices, significant patient motion, or procedure-related events were excluded. Phase standard deviation (PSD) and phase histogram bandwidth (PBW) were measured for assessment of LVMD. Patients were followed up for a median of 26 months after index MI, for composite major adverse cardiac events (MACE), which consisted with all-cause death, unplanned hospitalization due to heart failure and severe ventricular arrhythmias (sustained ventricular tachycardia or ventricular fibrillation). Independent predictors of MACE were evaluated.

Results

MACE occurred in 22 patients (20 %). Stress PSD (53.3 ± 17.3° vs. 35.3 ± 18.9°; p <0.001), stress PBW (147.6 ± 54.6° vs. 96.8 ± 59.2°; p = 0.001) and resting PBW (126.8 ± 37.5° vs. 96.6 ± 48.9°; p = 0.001) were significantly higher in patients with MACE compared to those without. Multivariate analysis revealed that stress PSD ≥45.5° and stress PBW ≥126.0° were predictive of MACE, as well as suboptimal non-culprit artery revascularization (SNR) and renin-angiotensin system (RAS) blockade medication. Higher stress PSD and stress PBW were associated with poorer prognosis both in patients with and without SNR, and those with RAS blockade medication, but not in those without RAS blockade medication.

Conclusions

LVMD measured by GMPS showed added prognostic value in acute MI with multivessel disease. GMPS could serve as a comprehensive evaluation imaging tool in patients with acute MI and multivessel disease.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Chonnam National University Hospital, Gwang-ju, Republic of Korea

    Sang-Geon Cho, Ki Seong Park, Jahae Kim, Jong Sang Kim & Ho-Chun Song

  2. Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, 322, Seoyang-ro Hwasun-eup, Hwasun-gun, Jeonnam, South Korea, 58128

    Zeenat Jabin, Sae-Ryung Kang, Seong Young Kwon, Geum-Cheol Jeong, Minchul Song, Jung-Joon Min & Hee-Seung Bom

  3. Department of Cardiology, Chonnam National University Hospital, Gwang-ju, Republic of Korea

    Jae Yeong Cho & Hyun Kuk Kim

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  1. Sang-Geon Cho
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Correspondence to Hee-Seung Bom.

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Conflict of interest

Sang-Geon Cho, Zeenat Jabin, Ki Seong Park, Jahae Kim, Sae-Ryung Kang, Seong Young Kwon, Geum-Cheol Jeong, Minchul Song, Jong Sang Kim, Jae Yeong Cho, Hyun Kuk Kim, Ho-Chun Song, Jung-Joon Min, and Hee-Seung Bom declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The requirement to obtain was waived in this retrospective study.

Additional information

Sang-Geon Cho and Zeenat Jabin equally contributed to this work as co-first authors.

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Cho, SG., Jabin, Z., Park, K.S. et al. Clinical values of left ventricular mechanical dyssynchrony assessment by gated myocardial perfusion SPECT in patients with acute myocardial infarction and multivessel disease. Eur J Nucl Med Mol Imaging 44, 259–266 (2017). https://doi.org/10.1007/s00259-016-3542-y

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  • DOI: https://doi.org/10.1007/s00259-016-3542-y

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