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LV dyssynchrony as assessed by phase analysis of gated SPECT myocardial perfusion imaging in patients with Wolff-Parkinson-White syndrome

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to evaluate left ventricular (LV) mechanical dyssynchrony in patients with Wolff-Parkinson-White (WPW) syndrome pre- and post-radiofrequency catheter ablation (RFA) using phase analysis of gated single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI).

Methods

Forty-five WPW patients were enrolled and had gated SPECT MPI pre- and 2–3 days post-RFA. Electrophysiological study (EPS) was used to locate accessory pathways (APs) and categorize the patients according to the AP locations (septal, left and right free wall). Electrocardiography (ECG) was performed pre- and post-RFA to confirm successful elimination of the APs. Phase analysis of gated SPECT MPI was used to assess LV dyssynchrony pre- and post-RFA.

Results

Among the 45 patients, 3 had gating errors, and thus 42 had SPECT phase analysis. Twenty-two patients (52.4 %) had baseline LV dyssynchrony. Baseline LV dyssynchrony was more prominent in the patients with septal APs than in the patients with left or right APs (p < 0.05). RFA improved LV synchrony in the entire cohort and in the patients with septal APs (p < 0.01).

Conclusion

Phase analysis of gated SPECT MPI demonstrated that LV mechanical dyssynchrony can be present in patients with WPW syndrome. Septal APs result in the greatest degree of LV mechanical dyssynchrony and afford the most benefit after RFA. This study supports further investigation in the relationship between electrical and mechanical activation using EPS and phase analysis of gated SPECT MPI.

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Acknowledgment

This study was supported in part by an NIH grant (1R01HL094438, PI: Ji Chen, PhD). Dr. Ji Chen receives royalties from the sale of Emory SyncTool. The terms of this arrangement have been reviewed and approved by Emory University in accordance with its conflict-of-interest practice.

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Authors and Affiliations

  1. Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Rd, Nanjing, Jiangsu, 210029, China

    Chun Chen, Dianfu Li, Changqing Miao, Yanli Zhou & Kejiang Cao

  2. Department of Nuclear Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China

    Jianlin Feng

  3. Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA

    Michael S. Lloyd

  4. Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA

    Ji Chen

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  1. Chun Chen
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  2. Dianfu Li
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  3. Changqing Miao
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  4. Jianlin Feng
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  5. Yanli Zhou
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  6. Kejiang Cao
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  7. Michael S. Lloyd
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  8. Ji Chen
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Correspondence to Dianfu Li.

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Chen, C., Li, D., Miao, C. et al. LV dyssynchrony as assessed by phase analysis of gated SPECT myocardial perfusion imaging in patients with Wolff-Parkinson-White syndrome. Eur J Nucl Med Mol Imaging 39, 1191–1198 (2012). https://doi.org/10.1007/s00259-012-2101-4

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  • DOI: https://doi.org/10.1007/s00259-012-2101-4

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