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Prognostic value of left ventricular mechanical dyssynchrony indices derived from gated myocardial perfusion SPECT in coronary artery disease: a systematic review and meta-analysis

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Abstract

Purpose

Left ventricular mechanical dyssynchrony (LVMD) is an important prognostic factor in coronary artery disease. A growing body of evidence indicates that LVMD parameters derived from phase analysis of gated myocardial SPECT may allow risk stratification for future cardiac events. We performed a systematic review and meta-analysis on the prognostic value of LVMD on gated SPECT in patients with coronary artery disease.

Methods

PubMed, Embase, and the Cochrane library were searched until August 25, 2022, for studies reporting the prognostic value of LVMD on gated SPECT for outcomes of all-cause death, cardiac death, or major adverse cardiovascular event (MACE) in patients with coronary artery disease. Hazard ratios (HRs) and their 95% confidence intervals (CIs) were meta-analytically pooled using a random-effects model.

Results

Nine studies (26,750 patients) were included in a qualitative synthesis. Among the SPECT LVMD parameters used in various studies, high phase standard deviation, phase bandwidth, and phase entropy were widely evaluated and reported to be associated with high rates of all-cause death, cardiac death, or MACE. For five studies (23,973 patients) in the quantitative synthesis, the pooled HR of LVMD for predicting MACE was 2.81 (95% CI 2.03–3.88). Studies using combined phase parameters to define LVMD showed higher HRs than a study using phase entropy (p = 0.0180).

Conclusion

LVMD from gated myocardial SPECT is a significant prognostic factor for coronary artery disease. Phase analysis of gated SPECT may be useful for accurate risk stratification and could be applied for clinical decision-making in such patients.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Funding

This research was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HR18C0016).

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Authors and Affiliations

  1. Department of Nuclear Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Koeun Lee

  2. Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-gu, Seoul, 05505, Republic of Korea

    Sangwon Han, Jeongryul Ryu & Dae Hyuk Moon

  3. Department of Nuclear Medicine, Chonnam National University Hospital, Gwang-ju, Republic of Korea

    Sang-Geon Cho

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Contributions

Koeun Lee and Sangwon Han contributed to study conceptualization, data acquisition, data analysis, data interpretation, writing, and editing of the manuscript. Jeongryul Ryu and Sang-Geon Cho contributed to data acquisition and editing of the manuscript. Dae Hyuk Moon contributed to data interpretation and editing of the manuscript. All authors have read and approved the final manuscript.

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Correspondence to Sangwon Han.

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Lee, K., Han, S., Ryu, J. et al. Prognostic value of left ventricular mechanical dyssynchrony indices derived from gated myocardial perfusion SPECT in coronary artery disease: a systematic review and meta-analysis. Ann Nucl Med (2024). https://doi.org/10.1007/s12149-024-01915-7

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