Left ventricular mechanical dyssynchrony assessment in obese patients using the cadmium-zinc telluride SPECT camera
The use of phase analysis techniques to assess left ventricular mechanical dyssynchrony (LVMD) has been well documented. However, artifacts have reduced the accuracy of the assessment due to soft tissue attenuation, so little information is available about the effects of obesity on LVMD. The aim of this study was to evaluate LVMD in patients with simple obesity by SPECT with a new cadmium-zinc telluride (CZT) detector and to explore the effects of obesity on left ventricular wall motion. We retrospectively analyzed 95 patients with myocardial perfusion imaging (MPI) images without perfusion defects, of which 55 were diagnosed with simple obesity (BMI > 30), and 40 non-obese patients (BMI < 25) matched for age and sex were used as controls. The five-point method was used to analyze the MPI images of the two groups, and the complete cardiac function parameters including phase bandwidth (PBW) and phase standard deviation (PSD) were obtained. Although the PBW values of the two groups were within the normal range (cut-off value > 90°), the PBW (35.4 ± 28 vs 24.9 ± 7.5, P < .001; 36.6 ± 18.4 vs 28.7 ± 9.1, P = 0.01) and PSD (8.7 ± 7.6 vs 5.9 ± 2, P = 0.02; 9.2 ± 4.9 vs 7.1 ± 2.7, P = 0.01) of the obese group were larger than the control group under both stressing and resting, and the difference was statistically significant. CZT-SPECT can effectively assess LVMD in obese patients, and they are more likely to develop LVMD, which may be related to their left ventricular volume.
KeywordsLeft ventricular mechanical dyssynchrony Phase analysis Phase standard deviation Phase bandwidth
Left ventricular mechanical dyssynchrony
Coronary artery disease
Myocardial perfusion imaging
Phase standard deviation
Left ventricular ejction fraction
End systolic volume
End diastolic volume
Funding was provided by The National Key Research and Development Program Of China (Grant No. 2016YFC0104303).
Compliance with ethical standards
Conflict of interest
There is no potential conflict of interest to disclose.
- 4.Hess PL, Shaw LK, Fudim M, Iskandrian AE, Borges-Neto S (2017) The prognostic value of mechanical left ventricular dyssynchrony defined by phase analysis from gated single-photon emission computed tomography myocardial perfusion imaging among patients with coronary heart disease. J Nucl Cardiol 24(2):482–490CrossRefGoogle Scholar
- 6.Cho SG, Jabin Z, Park KS, Kim J, Kang SR, Kwon SY, Jeong GC, Song M, Kim JS, Cho JY, Kim HK, Song HC, Min JJ, Bom HS (2017) 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(2):259–266CrossRefGoogle Scholar
- 15.Global BMI Mortality Collaboration, Di Angelantonio E, Bhupathiraju ShN, Wormser D, Gao P, Kaptoge S, Berrington de Gonzalez A, Cairns BJ, Huxley R, Jackson ChL, Joshy G, Lewington S, Manson JE, Murphy N, Patel AV, Samet JM, Woodward M, Zheng W, Zhou M, Bansal N, Barricarte A, Carter B, Cerhan JR, Smith GD, Fang X et al (2016) Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet (London, England) 388(10046):776–786CrossRefGoogle Scholar
- 16.Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, Mullany EC, Biryukov S, Abbafati C, Abera SF, Abraham JP, Abu-Rmeileh NM, Achoki T, AlBuhairan FS, Alemu ZA, Alfonso R, Ali MK, Ali R, Guzman NA, Ammar W, Anwari P, Banerjee A, Barquera S, Basu S, Bennett DA et al (2014) Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet (London, England) 384(9945):766–781CrossRefGoogle Scholar
- 17.Lu Y, Hajifathalian K, Ezzati M, Woodward M, Rimm EB, Danaei G (2014) Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1·8 million participants. Lancet (London, England) 383(9921):970–983CrossRefGoogle Scholar
- 23.Nakazato R, Slomka PJ, Fish M, Schwartz RG, Hayes SW, Thomson LE, Friedman JD, Lemley M, Mackin ML, Peterson B, Schwartz AM, Doran JA, Germano G, Berman DS (2015) Quantitative high-efficiency cadmium-zinc-telluride SPECT with dedicated parallel-hole collimation system in obese patients: results of a multi-center study. J Nucl Cardiol 22(2):266–275CrossRefGoogle Scholar