Abstract
Myocardial perfusion-single-photon emission computed tomography (MP-SPECT) is used to evaluate microvascular dysfunction and coexisting coronary artery disease in patients with hypertrophic cardiomyopathy (HCM). Phase analysis in gated MP-SPECT can provide additional information on left ventricular (LV) dyssynchrony, while the extent of late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) imaging is an important prognostic factor in patients with HCM. We, therefore, sought to investigate the relationship of dyssynchrony by phase analysis on gated MP-SPECT and LGE on CMR imaging in 22 patients with HCM who underwent both stress/rest-gated MP-SPECT and contrast-enhanced CMR imaging. LV dyssynchrony parameters [phase standard deviation (SD) and histogram bandwidth] from gated MP-SPECT were compared with LGE parameters from CMR imaging [L/C contrast and %LGE calculated, respectively, as LGE intensity/LV cavity intensity and (LGE volume/myocardial volume) × 100]. Phase SD and histogram bandwidth showed strong correlation with %LGE (r = 0.73, p < 0.0001 and r = 0.73, p < 0.0001, respectively), although they did not significantly correlate with L/C contrast (r = 0.30, p = 0.17 and r = 0.26, p < 0.25, respectively). The LV dyssynchrony derived from gated MP-SPECT strongly correlated with the extent of LGE on CMR imaging. In conclusion, our investigation suggests that gated MP-SPECT may be useful not only for the assessment of myocardial ischemia but also the extent of myocardial replacement fibrosis.
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Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, Naidu SS, Nishimura RA, Ommen SR, Rakowski H, Seidman CE, Towbin JA, Udelson JE, Yancy CW, American College of Cardiology Foundation/American Heart Association Task Force on Practice G, American Association for Thoracic S, American Society of E, American Society of Nuclear C, Heart Failure Society of A, Heart Rhythm S, Society for Cardiovascular A, Interventions and Society of Thoracic S (2011) 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 124:2761–2796
Choudhury L, Rigolin VH, Bonow RO (2017) Integrated imaging in hypertrophic cardiomyopathy. Am J Cardiol 119:328–339
Maron BJ (2002) Hypertrophic cardiomyopathy: a systematic review. JAMA 287:1308–1320
Hartlage GR, Kim JH, Strickland PT, Cheng AC, Ghasemzadeh N, Pernetz MA, Clements SD, Williams BR 3rd (2015) The prognostic value of standardized reference values for speckle-tracking global longitudinal strain in hypertrophic cardiomyopathy. Int J Cardiovasc Imaging 31:557–565
Fluechter S, Kuschyk J, Wolpert C, Doesch C, Veltmann C, Haghi D, Schoenberg SO, Sueselbeck T, Germans T, Streitner F, Borggrefe M, Papavassiliu T (2010) Extent of late gadolinium enhancement detected by cardiovascular magnetic resonance correlates with the inducibility of ventricular tachyarrhythmia in hypertrophic cardiomyopathy. J Cardiovasc Magn Reson 12:30
Zhu Y, Park EA, Lee W, Kim HK, Chu A, Chung JW, Park JH (2015) Extent of late gadolinium enhancement at right ventricular insertion points in patients with hypertrophic cardiomyopathy: relation with diastolic dysfunction. Eur Radiol 25:1190–1200
Rubinshtein R, Glockner JF, Ommen SR, Araoz PA, Ackerman MJ, Sorajja P, Bos JM, Tajik AJ, Valeti US, Nishimura RA, Gersh BJ (2010) Characteristics and clinical significance of late gadolinium enhancement by contrast-enhanced magnetic resonance imaging in patients with hypertrophic cardiomyopathy. Circ Heart Fail 3:51–58
Chan RH, Maron BJ, Olivotto I, Pencina MJ, Assenza GE, Haas T, Lesser JR, Gruner C, Crean AM, Rakowski H, Udelson JE, Rowin E, Lombardi M, Cecchi F, Tomberli B, Spirito P, Formisano F, Biagini E, Rapezzi C, De Cecco CN, Autore C, Cook EF, Hong SN, Gibson CM, Manning WJ, Appelbaum E, Maron MS (2014) Prognostic value of quantitative contrast-enhanced cardiovascular magnetic resonance for the evaluation of sudden death risk in patients with hypertrophic cardiomyopathy. Circulation 130:484–495
Masci PG, Barison A, Aquaro GD, Pingitore A, Mariotti R, Balbarini A, Passino C, Lombardi M, Emdin M (2012) Myocardial delayed enhancement in paucisymptomatic nonischemic dilated cardiomyopathy. Int J Cardiol 157:43–47
Fujita T, Konno T, Yokawa J, Masuta E, Nagata Y, Fujino N, Funada A, Hodatsu A, Kawashiri MA, Yamagishi M, Hayashi K (2015) Increased extent of myocardial fibrosis in genotyped hypertrophic cardiomyopathy with ventricular tachyarrhythmias. J Cardiol 66:63–68
Elliott PM, Anastasakis A, Borger MA, Borggrefe M, Cecchi F, Charron P, Hagege AA, Lafont A, Limongelli G, Mahrholdt H, McKenna WJ, Mogensen J, Nihoyannopoulos P, Nistri S, Pieper PG, Pieske B, Rapezzi C, Rutten FH, Tillmanns C, Watkins H (2014) 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the task force for the diagnosis and management of hypertrophic cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J 35:2733–2779
Cecchi F, Olivotto I, Gistri R, Lorenzoni R, Chiriatti G, Camici PG (2003) Coronary microvascular dysfunction and prognosis in hypertrophic cardiomyopathy. N Engl J Med 349:1027–1035
Dilsizian V, Bonow RO, Epstein SE, Fananapazir L (1993) Myocardial ischemia detected by thallium scintigraphy is frequently related to cardiac arrest and syncope in young patients with hypertrophic cardiomyopathy. J Am Coll Cardiol 22:796–804
Henneman MM, van der Wall EE, Ypenburg C, Bleeker GB, van de Veire NR, Marsan NA, Chen J, Garcia EV, Westenberg JJ, Schalij MJ, Bax JJ (2007) Nuclear imaging in cardiac resynchronization therapy. J Nucl Med 48:2001–2010
Trimble MA, Borges-Neto S, Honeycutt EF, Shaw LK, Pagnanelli R, Chen J, Iskandrian AE, Garcia EV, Velazquez EJ (2008) Evaluation of mechanical dyssynchrony and myocardial perfusion using phase analysis of gated SPECT imaging in patients with left ventricular dysfunction. J Nucl Cardiol 15:663–670
Chen J, Garcia EV, Bax JJ, Iskandrian AE, Borges-Neto S, Soman P (2011) SPECT myocardial perfusion imaging for the assessment of left ventricular mechanical dyssynchrony. J Nucl Cardiol 18:685–694
Nagakura T, Takeuchi M, Yoshitani H, Nakai H, Nishikage T, Kokumai M, Otani S, Yoshiyama M, Yoshikawa J (2007) Hypertrophic cardiomyopathy is associated with more severe left ventricular dyssynchrony than is hypertensive left ventricular hypertrophy. Echocardiography 24:677–684
Germano G, Kiat H, Kavanagh PB, Moriel M, Mazzanti M, Su HT, Van Train KF, Berman DS (1995) Automatic quantification of ejection fraction from gated myocardial perfusion SPECT. J Nucl Med 36:2138–2147
Nakae I, Hayashi H, Matsumoto T, Mitsunami K, Horie M (2014) Clinical usefulness of a novel program “Heart Function View” for evaluating cardiac function from gated myocardial perfusion SPECT. Ann Nucl Med 28:812–823
Nakajima K, Okuda K, Matsuo S, Kiso K, Kinuya S, Garcia EV (2017) Comparison of phase dyssynchrony analysis using gated myocardial perfusion imaging with four software programs: based on the Japanese Society of Nuclear Medicine working group normal database. J Nucl Cardiol 24:611–621
Nakajima K (2010) Normal values for nuclear cardiology: Japanese databases for myocardial perfusion, fatty acid and sympathetic imaging and left ventricular function. Ann Nucl Med 24:125–135
Takashio S, Yamamuro M, Uemura T, Utsunomiya D, Morita K, Izumiya Y, Sugiyama S, Kojima S, Yamamoto E, Tsujita K, Tanaka T, Tayama S, Kaikita K, Hokimoto S, Yasuda O, Yamashita Y, Ogawa H (2014) Correlation between extent of myocardial fibrosis assessed by cardiac magnetic resonance and cardiac troponin T release in patients with nonischemic heart failure. Am J Cardiol 113:1697–1704
Moon JC, McKenna WJ, McCrohon JA, Elliott PM, Smith GC, Pennell DJ (2003) Toward clinical risk assessment in hypertrophic cardiomyopathy with gadolinium cardiovascular magnetic resonance. J Am Coll Cardiol 41:1561–1567
Hurtado-de-Mendoza D, Corona-Villalobos CP, Pozios I, Gonzales J, Soleimanifard Y, Sivalokanathan S, Montoya-Cerrillo D, Vakrou S, Kamel I, Mormontoy-Laurel W, Dolores-Cerna K, Suarez J, Perez-Melo S, Bluemke DA, Abraham TP, Zimmerman SL, Abraham MR (2017) Diffuse interstitial fibrosis assessed by cardiac magnetic resonance is associated with dispersion of ventricular repolarization in patients with hypertrophic cardiomyopathy. J Arrhythm 33:201–207
Maron MS (2012) Clinical utility of cardiovascular magnetic resonance in hypertrophic cardiomyopathy. J Cardiovasc Magn Reson 14:13
Arreola J, Dirksen RT, Shieh RC, Williford DJ, Sheu SS (1991) Ca2+ current and Ca2+ transients under action potential clamp in guinea pig ventricular myocytes. Am J Physiol 261:C393–C397
Barletta G, Lazzeri C, Franchi F, Del Bene R, Michelucci A (2004) Hypertrophic cardiomyopathy: electrical abnormalities detected by the extended-length ECG and their relation to syncope. Int J Cardiol 97:43–48
Badran HM, Elnoamany MF, Soltan G, Ezat M, Elsedi M, Abdelfatah RA, Yacoub M (2012) Relationship of mechanical dyssynchrony to QT interval prolongation in hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging 13:423–432
O’Hanlon R, Grasso A, Roughton M, Moon JC, Clark S, Wage R, Webb J, Kulkarni M, Dawson D, Sulaibeekh L, Chandrasekaran B, Bucciarelli-Ducci C, Pasquale F, Cowie MR, McKenna WJ, Sheppard MN, Elliott PM, Pennell DJ, Prasad SK (2010) Prognostic significance of myocardial fibrosis in hypertrophic cardiomyopathy. J Am Coll Cardiol 56:867–874
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Yuki, H., Utsunomiya, D., Shiraishi, S. et al. Correlation of left ventricular dyssynchrony on gated myocardial perfusion SPECT analysis with extent of late gadolinium enhancement on cardiac magnetic resonance imaging in hypertrophic cardiomyopathy. Heart Vessels 33, 623–629 (2018). https://doi.org/10.1007/s00380-017-1104-2
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DOI: https://doi.org/10.1007/s00380-017-1104-2