Journal of Nuclear Cardiology

, Volume 22, Issue 6, pp 1247–1258 | Cite as

Cut-off values of myocardial perfusion gated-SPECT phase analysis parameters of normal subjects, and conduction and mechanical cardiac diseases

  • Guillermo Romero-FarinaEmail author
  • Santiago Aguadé-Bruix
  • Jaume Candell-Riera
  • María N. Pizzi
  • David García-Dorado
Review Article



The aim of this study was to determine the cut-off values of gated myocardial perfusion rest SPECT phase analysis parameters of normal subjects, and conduction (CCD) and mechanical cardiac diseases (MCD).


We prospectively analyzed 455 patients by means of phase analysis using SyncTool™ (Emory Cardiac Toolbox™). Of these, 150 corresponded to the control group (group 1, normal subjects) and 305 corresponded to patients with cardiac diseases (group 2, 63 with only CCD, 121 with only MCD, and 121 with CCD plus MCD). The optimal cut-off (CO) values of the peak phase (P), standard deviation (SD), bandwidth (B), skewness (S), and kurtosis (K) for discriminating between normal and dyssynchrony were obtained.


In order to differentiate group 1 from group 2, CO of SD > 18.4 and CO of B > 51 were the most sensitive parameters (75.7%, 95% CI 70.5%-80.4%, and 78.7%, 95% CI 73.7%-83.1%, respectively), and CO of S ≤ 3.2 and CO of K ≤ 9.3 were the most specific (92%, 95% CI 86.4%-95.8%, and 94.7%, 95% CI 89.8%-97.7%, respectively). In order to differentiate patients with CCD and MCD, CO values were SD > 26.1, B > 70, S ≤ 2.89, and K ≤ 10.2. In order to differentiate between patients with (n: 26) and without (n: 216) criteria of cardiac resynchronization therapy, CO values were SD > 40.2, B > 132, S ≤ 2.3, and K ≤ 4.6.


In this pilot study, different CO values of phase histogram parameters were observed between normal subjects and patients with conduction and MCD, and between patients with and without criteria of cardiac resynchronization therapy.


Left ventricular dyssynchrony gated-SPECT myocardial perfusion imaging phase analysis cut-off values 



Area under the curve




Conduction cardiac diseases






Left ventricle


Mechanical cardiac diseases


Peak phase




Standard deviation



The authors wish to acknowledge Dr Ernest García for his help in developing this study and Prof Demos Demosthenous (London) for his grammatical English correction.


The authors declare that they have no financial conflicts of interest.


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Copyright information

© American Society of Nuclear Cardiology 2015

Authors and Affiliations

  • Guillermo Romero-Farina
    • 1
    • 2
    Email author
  • Santiago Aguadé-Bruix
    • 2
  • Jaume Candell-Riera
    • 1
  • María N. Pizzi
    • 1
  • David García-Dorado
    • 1
  1. 1.Cardiology Department, Hospital Universitari Vall d’Hebron, Institut de Recerca (VHIR)Universitat Autònoma de BarcelonaBarcelonaSpain
  2. 2.Department of Nuclear Medicine, Hospital Universitari Vall d’Hebron, Institut de Recerca (VHIR)Universitat Autònoma de BarcelonaBarcelonaSpain

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