Skip to main content

Relationship between left ventricular function and wall motion synchrony in heart failure assessed by ECG-gated myocardial perfusion SPECT

Annals of Nuclear Medicine volume 22, pages 751–759 (2008)Cite this article

Abstract

Objective

To confirm the relationship between left ventricular (LV) function and wall motion synchrony, and to identify the difference of synchrony between an ischemic heart disease (IHD) patient group and other heart disease (OHD) patient group among classified groups in heart failure, systolic, and diastolic parameters were compared using electrocardiograph-gated single-photon emission computed tomography.

Methods and results

Twenty IHD and 30 OHD patient groups, comprised New York Heart Association functional class I–III (IHD1-3 and OHD1-3), and 15 controls were examined. The LV functions (ejection fraction, EF; peak-filling rate, PFR) and synchrony, which was estimated from the time lag between the earliest and latest regional systolic or diastolic temporal parameters (maximum difference of regional time to end-systole, MD-TES, or maximum difference of regional time to peak filling, MD-TPF), were compared. The LV function correlated with its synchrony in IHD and OHD (EF vs. MD-TES: r = −0.86, P = 1.3 × 10−6 in IHD and r = −0.69, P = 2.8 × 10−5 in OHD. PFR versus MD-TPF: r = −0.67, P < 0.002 in IHD and r = −0.63, P < 0.0002 in OHD). Dyssynchronous normal EF was observed in three IHD (15%) and six OHD (20%). Dyssynchronous normal PFR was observed in six IHD (30%) and six OHD (20%). MD-TES was significantly smaller in control group (CG) than in IHD3 and OHD3 (P < 0.005), and in IHD1 than in IHD3 and OHD3 (P < 0.05). MD-TPF was significantly smaller in CG than in IHD2, IHD3, and OHD3 (P < 0.05). However, there was no significant difference between LV synchrony in IHD and OHD, or among LV synchrony of the same functional classes between these two groups.

Conclusions

This study confirms that LV function is correlated with wall motion synchrony. No statistically significant difference was confirmed in wall motion synchrony between IHD and OHD. However, dyssynchrony appears in the patients without apparent global LV dysfunction. This feature may facilitate identification of synchronous disorder in HF patients with preserved global LV function. It is expected that detection of such a disorder may lead to the initiation of appropriate treatments for early stage HF and prevent its progression.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Ratib O, Henze E, Schön H, Schelbert HR. Phase analysis of radionuclide ventriculograms for the detection of coronary artery disease. Am Heart J 1982;104:1–12.

    PubMed  Article  CAS  Google Scholar 

  2. Pavel DG, Byrom E, Lam W, Meyer-Pavel C, Swiryn S, Pietras R. Detection and quantification of regional wall motion abnormalities using phase analysis of equilibrium gated cardiac studies. Clin Nucl Med 1983;8:315–321.

    PubMed  Article  CAS  Google Scholar 

  3. Chen J, Garcia EV, Folks RD, Cooke CD, Faber TL, Tauxe EL, et al. Onset of LV mechanical contraction as determined by phase analysis of ECG-gated myocardial perfusion SPECT imaging: development of a diagnostic tool for assessment of cardiac mechanical dyssynchrony. J Nucl Cardiol 2005;12:687–695.

    PubMed  Article  Google Scholar 

  4. Hannerman MM, Chen J, Ypenburg C, Dibbets P, Bleeker GB, Boersma E, et al. Phase analysis of gated myocardial perfusion single-photon emission computed tomography compared with tissue Doppler imaging for the assessment of left ventricular dyssynchrony. J Am Coll Cardiol 2007;49:1708–1714.

    Article  Google Scholar 

  5. Hannerman MM, Chen J, Dibbets-Schneider P, Stokkel MP, Bleeker GB, Ypenburg C, et al. Can LV dyssynchrony as assessed with phase analysis on gated myocardial perfusion SPECT predict response to CRT? J Nucl Med 2007;48:1104–1108.

    Article  Google Scholar 

  6. Vasan RS, Levy D. Defining diastolic heart failure: a call for standardized diagnostic criteria. Circulation 2000;101:2118–21121.

    PubMed  CAS  Google Scholar 

  7. Grossman WG. Defining diastolic dysfunction. Circulation 2000;101:2020–2021.

    PubMed  CAS  Google Scholar 

  8. Wang J, Kurrelmeyer KM, Torre-Amione G, Nagueh SF. Systolic and diastolic dyssynchrony in patients with diastolic heart failure and the effect of medical therapy. J Am Coll Cardiol 2007;49:88–96.

    PubMed  Article  Google Scholar 

  9. Yamamoto A, Hosoya T, Takahashi N, Iwahara S, Munakata K. Quantification of left ventricular regional functions using ECG-gated myocardial perfusion SPECT: validation of left ventricular systolic functions. Ann Nucl Med 2006;20:449–456.

    PubMed  Article  Google Scholar 

  10. Yamamoto A, Takahashi N, Munakata K, Hosoya T, Shiiba M, Okuyama T, et al. Global and regional evaluation of systolic and diastolic left ventricular temporal parameters using a novel program for ECG-gated myocardial perfusion SPECT: validation by comparison with gated equilibrium radionuclide angiography and speckle-tracking radial strain from echocardiography. Ann Nucl Med 2007;21:115–121.

    PubMed  Article  Google Scholar 

  11. Yamamoto A, Takahashi N, Munakata K, Abe K, Kobayashi Y, Tamai J, et al. Relationships among regional diastolic impairment, elongation of global time to peak filling rate, and diastolic function using ECG-gated myocardial perfusion SPECT in heart failure. Ann Nucl Med 2007;21:419–427.

    PubMed  Article  Google Scholar 

  12. Takahashi N, Yamamoto A, Tezuka S, Ishikawa M, Abe J, Amitani K, et al. Assessment of left ventricular dyssynchrony during development of heart failure by a novel program using ECG-gated myocardial perfusion SPECT. Circ J 2008;72:370–377.

    PubMed  Article  Google Scholar 

  13. Mckee PA, Casteli WP, McNamara PM, Kannel WP. The natural history of congestive heart failure: the Framingham study. N Engl J Med 1971;285:1441–1446.

    PubMed  CAS  Google Scholar 

  14. Nakata T, Katagiri Y, Odawara Y, Eguchi M, Kuroda M, Tsuchihashi K, et al. Two-and three-dimensional assessment of myocardial perfusion and function by using technetium-99m sestamibi gated SPECT with a combination of count and image-based techniques. J Nucl Cardiol 2000;7:623–632.

    PubMed  Article  CAS  Google Scholar 

  15. Hashimoto A, Nakata T, Wakabayashi T, Kyuma M, Takahashi T, Tsuchihashi K, et al. Validation of quantitative gated single photon emission computed tomography and an automated scoring system for the assessment of regional left ventricular systolic function. Nucl Med Commun 2002;23:887–898.

    PubMed  Article  CAS  Google Scholar 

  16. Kasai T, Depuey EG, Shah AA. Compared with 3-dimensional analysis, 2-dimensional gated SPECT analysis overestimates left ventricular ejection fraction in patients with regional dyssynchrony. J Nucl Cardiol 2004;11:159–164.

    PubMed  Article  Google Scholar 

  17. Kasai T, Depuey EG, Shah AA. Decreased septal wall thickening in patients with left bundle branch block. J Nucl Cardiol 2004;11:32–37.

    PubMed  Article  Google Scholar 

  18. American Heart Association Working group. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the Cardiac Imaging Committee of the Council Cardiology of the American Heart Association. Circulation 2002;105:539–542.

    Article  Google Scholar 

  19. Nakajima K, Taki J, Kawano M, Higuchi T, Sato S, Nishijima C, et al. Diastolic dysfunction in patients with systemic sclerosis detected by gated myocardial perfusion SPECT: an early sigh of cardiac involvement. J Nucl Med 2001;42:183–188.

    PubMed  CAS  Google Scholar 

  20. Akincioglu C, Berman DS, Nishina H, Kavanagh PB, Slomka P, Abidov A, et al. Assessment of diastolic function using 16-frame 99mTc-sestamibi gated myocardial perfusion SPECT: Normal values. J Nucl Med 2005;46:1102–1108.

    PubMed  Google Scholar 

Download references

Author information

Affiliations

  1. Department of Radiology, Nippon Medical School, Tamanagayama Hospital, 1-7-1 Nagayama, Tama, Tokyo, 206-8512, Japan

    Akira Yamamoto, Kazuya Abe, Yuko Kobayashi & Jin Tamai

  2. Department of Internal Medicine, Nippon Medical School, Musashikosugi Hospital, Kawasaki, Kanagawa, Japan

    Naoto Takahashi, Masahiro Ishikawa & Kazuo Munakata

Authors
  1. Akira Yamamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Naoto Takahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masahiro Ishikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kazuya Abe
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yuko Kobayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jin Tamai
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kazuo Munakata
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Akira Yamamoto.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Yamamoto, A., Takahashi, N., Ishikawa, M. et al. Relationship between left ventricular function and wall motion synchrony in heart failure assessed by ECG-gated myocardial perfusion SPECT. Ann Nucl Med 22, 751–759 (2008). https://doi.org/10.1007/s12149-008-0172-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12149-008-0172-x

Keywords

  • Heart failure
  • Left ventricular function
  • Synchrony
  • Gated myocardial perfusion SPECT