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Journal of Nuclear Cardiology

, Volume 25, Issue 2, pp 625–634 | Cite as

Feasibility and accuracy of gated blood pool SPECT equilibrium radionuclide ventriculography for the assessment of left and right ventricular volumes and function in patients with left ventricular assist devices

  • Olivier Lairez
  • Clément Delmas
  • Pauline Fournier
  • Emmanuelle Cassol
  • Simon Méjean
  • Pierre Pascal
  • Antoine Petermann
  • Camille Dambrin
  • Vincent Minville
  • Didier Carrié
  • Hervé Rousseau
  • Michel Galinier
  • Jérôme Roncalli
  • Bertrand Marcheix
  • Isabelle Berry
Original Article

Abstract

Background

Left ventricular assist devices (LVADs) require serial assessment of right and left ventricular (RV & LV) volumes and function. Because the RV is not assisted, its function is a critical determinant of the hemodynamic and contributes significantly to postoperative morbidity and mortality. We evaluated the feasibility and the accuracy of tomographic-equilibrium radionuclide ventriculography (t-ERV) for the assessment of patients with LVADs.

Methods

Twenty-four patients with LVAD underwent t-ERV. Because of the limited acoustic window, transthoracic echocardiography (TTE) was only feasible in 19 patients. Functional evaluation including six-minute walk test (6MWT) and peak oxygen consumption (POC) was performed in 18 patients. Nine patients underwent a cardiac multidetector computed tomography (MDCT). Eight patients underwent a second evaluation by ERV 4.3 ± 1.4 months later.

Results

Reliability between t-ERV and MDCT for LV end-diastolic volume, LV end-systolic volume, LV ejection fraction, RV end-diastolic volume, RV end-systolic volume, and RV ejection fraction (RVEF) was 0.900 (P = .001), 0.911 (P = .001), 0.765 (P = .021), 0.728 (P = .042), 0.875 (P = .004), and 0.781 (P = .023), respectively. There was no correlation between t-ERV and RV systolic parameters assessed by TTE. RVEF was correlated with POC (R = 0.521; P = .027). A cut-off value of 40% for RVEF measured by t-ERV could discriminate patients with poor functional status (P = .048 for NYHA stage; P = .016 for 6MWT and P = .007 for POC).

Conclusion

t-ERV is a simple, reproducible, and an accurate technique for the assessment of RV function in patients with LVADs and warrants consideration in the evaluation and monitoring of symptomatic patients.

Keywords

Left ventricular assist device equilibrium radionuclide ventriculography SPECT right ventricle cardiac imaging 

Abbreviations

6MWT

6-Minute walk test

ERV

Equilibrium radionuclide ventriculography

LV

Left ventricular

LVAD

Left ventricular assist device

LVEF

Left ventricular ejection fraction

MDCT

Multidetector computed tomography

NT-proBNP

N-Terminal pro-hormone brain natriuretic peptide

p-ERV

Planar equilibrium radionuclide ventriculography

PSVtdi

Peak systolic velocity by tissue Doppler imaging

RV

Right ventricle

RVEF

Right ventricular ejection fraction

t-ERV

Tomographic-equilibrium radionuclide ventriculography

TAPSE

Tricuspid annular plane systolic excursion

TTE

Transthoracic echocardiography

Notes

Acknowledgements

The authors thank Bernard Estivals and the staff of the department of nuclear medicine of Rangueil for their technical support.

Disclosure

Olivier Lairez, Clément Delmas, Pauline Fournier, Emmanuelle Cassol, Simon Méjean, Pierre Pascal, Antoine Petermann, Camille Dambrin, Vincent Minville, Didier Carrié, Hervé Rousseau, Michel Galinier, Jérôme Roncalli, Bertrand Marcheix, Isabelle Berry have indicated that they have no financial conflict of interest.

Supplementary material

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Supplementary material 1 (MOV 341 kb)
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Supplementary material 2 (MOV 1053 kb)
12350_2016_670_MOESM3_ESM.pptx (1.1 mb)
Supplementary material 3 (PPTX 1095 kb)

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Copyright information

© American Society of Nuclear Cardiology 2016

Authors and Affiliations

  • Olivier Lairez
    • 1
    • 2
    • 3
    • 4
  • Clément Delmas
    • 2
    • 4
  • Pauline Fournier
    • 2
    • 3
  • Emmanuelle Cassol
    • 1
    • 4
  • Simon Méjean
    • 1
    • 2
    • 3
    • 4
  • Pierre Pascal
    • 1
    • 3
  • Antoine Petermann
    • 3
    • 5
  • Camille Dambrin
    • 4
    • 6
  • Vincent Minville
    • 4
    • 7
  • Didier Carrié
    • 2
    • 3
    • 8
  • Hervé Rousseau
    • 3
    • 4
    • 5
  • Michel Galinier
    • 2
    • 3
    • 4
  • Jérôme Roncalli
    • 2
    • 8
  • Bertrand Marcheix
    • 4
    • 6
  • Isabelle Berry
    • 1
    • 3
    • 4
  1. 1.Department of Nuclear MedicineUniversity Hospital of RangueilToulouseFrance
  2. 2.Department of CardiologyUniversity Hospital of RangueilToulouseFrance
  3. 3.Cardiac Imaging CenterToulouse University HospitalToulouseFrance
  4. 4.Medical School of RangueilUniversity Paul SabatierToulouseFrance
  5. 5.Department of RadiologyToulouse University HospitalToulouseFrance
  6. 6.Department of Cardiac SurgeryToulouse University HospitalToulouseFrance
  7. 7.Department of AnesthesiologyToulouse University HospitalToulouseFrance
  8. 8.Medical School of PurpanUniversity Paul SabatierToulouseFrance

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