Assessment of left ventricular mechanical dyssynchrony (LVMD) from gated SPECT myocardial perfusion imaging (MPI) aims to aid selection of patients for cardiac resynchronization therapy (CRT), using either the standard deviation of left ventricular phase (PSD) ≥ 43° or phase histogram bandwidth (HBW) of > 38° and > 30.6° in males and females, respectively. We observed dyssynchrony parameters might be affected by test type and alignment.
We reviewed 242 patients who underwent gated SPECT MPI with use of the Emory Cardiac Toolbox comparing PSD and HBW at rest and stress for Pearson correlation, and substitutability with Bland–Altman analysis.
There is statistically significant difference in the mean PSD and HBW during rest vs stress (33.4 ± 17.4° vs 20.7 ± 13.5° and 97.7 ± 59.6° vs 59.4 ± 45.4°, respectively, P < 0.001). Proper valve plane alignment rendered smaller values (i.e., less dyssynchrony) in both phase SD and HBW (16.8 ± 13.5) vs (22.2 ± 14.7) (P = 0.011), and (47.0 ± 38.2) vs (60.7 ± 48.0) (P = 0.023), respectively.
Proper alignment and test type, particularly low-dose rest vs high-dose stress, should be considered when assessing LVMD using SPECT MPI.
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Left ventricular mechanical dyssynchrony
Cardiac resynchronization therapy
Heart failure with preserved ejection fraction
Single-photon emission computerized tomography
Myocardial perfusion imaging
Standard deviation of left ventricular phase
American Society of Nuclear Cardiology
Transient ischemic dilation
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Omaima Ali, Maithili Shenoy, Anas Alani, Maath Alani, and Kim Williams declare that they have no conflict of interest.
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Ali, O., Shenoy, M., Alani, A. et al. Are SPECT MPI measures of dyssynchrony dyssynchronous?. J. Nucl. Cardiol. (2020). https://doi.org/10.1007/s12350-019-02024-z
- image interpretation