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Prognostic Value of Early Evaluation of Left Ventricular Dyssynchrony After Myocardial Infarction

  • Hiroshi WakabayashiEmail author
  • Junichi Taki
  • Anri Inaki
  • Tomo Hiromasa
  • Takafumi Yamase
  • Norihito Akatani
  • Koichi Okuda
  • Takayuki Shibutani
  • Kazuhiro Shiba
  • Seigo Kinuya
Research Article
  • 61 Downloads

Abstract

Purpose

Dispersion in the contraction of the normally coordinate ventricular system, referred to as left ventricular (LV) dyssynchrony, is constantly observed at different grades of severity after myocardial infarction (MI). We aimed to investigate the prognostic value of early dyssynchrony in adverse cardiac events after MI in a rat model using the quantified gated single photon emission tomography (SPECT; QGS) software.

Procedures

After thoracotomy, the left coronary arteries of 16 rats were occluded and reperfused. SPECT was performed with [99m Tc]methoxyisobutylisonitrile 3 days, 1 week, 2 weeks, 4 weeks, and 8 weeks after MI. The phase analysis parameters including mean phase standard deviation (PSD), bandwidth (BW), entropy, and LV function were analyzed by the QGS software. A receiver operating characteristic curve was used to explore the predictors for cardiac death and severe cardiac failure (ejection fraction [EF] < 35 %). A Kaplan–Meier event-free survival analysis, univariate, and multivariate Cox proportional hazards regression analyses were conducted.

Results

Four rats had died, whereas another four rats presented with severe heart failure. LV end-diastolic volume was increased during follow-up, but no significant changes were noted in the other parameters. The prognosis of rats with lower EF and higher end-diastolic and end-systolic volumes (ESV), PSD, BW, and entropy at 3 days after MI was poor. Adverse cardiac events were associated with lower EF (relative risk [RR] 13.1, 95 % confidence Interval [CI]: 2.1–259.9, P = 0.003), higher ESV (RR 6.4, CI 1.4–45.9, P = 0.01), and higher entropy (RR 4.3, 95 % CI: 1.0–21.8, P = 0.04) by univariate analysis. Multivariate analysis showed that lower EF was the most powerful independent predictor of adverse cardiac events (RR 16.0, CI 1.1–429.2, P = 0.03).

Conclusions

Severe early dyssynchrony evaluated by QGS after MI could predict cardiac events in the rat model in the same way as other cardiac function parameters including EF and ESV. The early assessment of dyssynchrony after MI may provide helpful information for the prediction of cardiac events in the future.

Key words

Dyssynchrony Phase analysis Acute myocardial infarction 

Notes

Compliance with Ethical Standards

The experimental protocol was approved by the animal protection commission of our university. All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.

Conflict of Interest

The authors declare that they have no competing interests.

Ethical Approval

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.

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Copyright information

© World Molecular Imaging Society 2018

Authors and Affiliations

  • Hiroshi Wakabayashi
    • 1
    Email author
  • Junichi Taki
    • 1
  • Anri Inaki
    • 1
  • Tomo Hiromasa
    • 1
  • Takafumi Yamase
    • 1
  • Norihito Akatani
    • 1
  • Koichi Okuda
    • 2
  • Takayuki Shibutani
    • 3
  • Kazuhiro Shiba
    • 4
  • Seigo Kinuya
    • 1
  1. 1.Department of Nuclear MedicineKanazawa University HospitalKanazawaJapan
  2. 2.Department of physicsKanazawa Medical UniversityKahokuJapan
  3. 3.Department of Quantum Medical TechnologyInstitute of Medical, Pharmaceutical and Health Sciences, Kanazawa UniversityKanazawaJapan
  4. 4.Division of Tracer Kinetics, Advanced Science Research CenterKanazawa UniversityKanazawaJapan

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