Comparison of the dyssynchrony parameters recorded with gated SPECT in ischemic cardiomyopathy according to their repeatability at rest and to their ability to detect a synchrony reserve under dobutamine infusion
This study aimed to determine whether the repeatability of dyssynchrony assessment using gated myocardial perfusion SPECT (GSPECT) allows the detection of synchrony reserve during low-dose dobutamine infusion.
Methods and Results
Sixty-one patients with ischemic cardiomyopathy and LV ejection fraction < 50% were prospectively included in 10 centers. Each patient underwent two consecutive rest GSPECT with 99mTc-labeled tracer (either tetrofosmin or sestamibi) to assess the repeatability of LV function and dyssynchrony parameters, followed by a GSECT acquisition during low-dose dobutamine infusion. LV dyssynchrony was assessed using QGS software through histogram bandwidth (BW), standard deviation of the phase (SD), and entropy. Repeatability was assessed with Lin’s concordance correlation coefficient (CCC). Entropy showed a higher CCC (0.80) compared to BW (0.68) and SD (0.75). On average, dobutamine infusion yielded to improve both BW (P = .049) and entropy (P = .04) although significant improvements, setting outside the 95% confidence interval of the repeatability analysis, were documented in only 6 and 4 patients for BW and entropy, respectively.
A synchrony reserve may be documented in patients with ischemic cardiomyopathy through the recording of BW and entropy with low-dose dobutamine GSPECT, with the additional advantage of a higher repeatability for entropy.
KeywordsGated single-photon emission computed tomography heart failure ischemic cardiomyopathy left ventricular dyssynchrony dobutamine infusion
Bandwidth of the phase
Concordance correlation coefficient
Low-dose dobutamine stress gated single-photon emission computed tomography
Gated myocardial perfusion single-photon emission computed tomography
Left ventricular ejection fraction
Standard deviation of the phase
Single-photon emission computed tomography
Summed rest score
Wall thickening score
Sabrina PROD’HOMME is acknowledged for her technical assistance. MJ Alibelli (Centre Hospitalier Universitaire Rangueil, Toulouse, France), H Benhabib (Centre Hospitalier de Corbeil, Corbeil, France), A Devillers (CRLCC Eugène Marquis, Rennes, France), V Eder (Centre Hospitalier Universitaire Trousseau, Tours, France), P Guillo (Centre Hospitalier Universitaire de la Cavale Blanche, Brest, France), JF Toussaint (Hôpital Européen George Pompidou, Paris, France), and P Weinmann (Hôpital Avicenne, Bobigny, France) are acknowledged for their participation in this study.
The authors have indicated that they have no financial conflict of interest.
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