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Effect of tracer dose on left ventricular mechanical dyssynchrony indices by phase analysis of gated single photon emission computed tomography myocardial perfusion imaging

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

There are limited data on the effect of tracer dose on the reproducibility and accuracy of left ventricular (LV) mechanical dyssynchrony indices by phase analysis of gated single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI).

Methods and Results

We measured LV dyssynchrony in 54 patients with normal LV ejection and perfusion (group 1) and 54 age and gender matched patients with LV ejection <35% (group 2) using phase analysis of gated SPECT MPI from stress (high dose) and rest (low dose) studies with 2 software programs: Corridor4DM (4DM) and Emory Cardiac Toolbox (ECTb). Although the correlation between rest- and stress-derived standard deviation was good (R = 0.76, P < .0001, with both software programs), there was considerable variability between the measurements (P < .0001 by paired t test). In addition, the rest standard deviation was significantly higher than stress in group 1 (10.2° ± 4.6° vs 6.1° ± 2.5°, and 12.2° ± 6.4° vs 7.9° ± 4.6°, with 4DM and ECTb, respectively, P < .0001 for both) and group 2 patients (44.0° ± 18.0° vs 35.9° ± 21.0° and 47.3° ± 19.2° vs 38.8° ± 19.8°, with 4DM and ECTb, P = .03 and .02, respectively). Similarly, the rest standard deviations were higher than the stress values irrespective of the type of stress test (i.e., exercise vs pharmacological), and the body mass index. Finally, using rest-derived dyssynchrony indices was associated with 9%-13% and 22%-26% false positive rate of significant mechanical dyssynchrony using different cut-off values for groups 1 and 2, respectively.

Conclusion

LV mechanical dyssynchrony indices by phase analysis have more variation and are significantly higher if derived from rest gated SPECT images obtained with low-dose tracer.

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Section of Cardiovascular Imaging, Cleveland Clinic, Cleveland, OH, USA

    Wael AlJaroudi MD, Wael A. Jaber MD & Manuel D. Cerqueira MD

  2. Robert and Suzanne Tomsich, Department of Cardiovascular Medicine, Sydell and Arnold Miller Family, Heart and Vascular Institute, 9500 Euclid Avenue/J1-5, Cleveland, OH, 44195, USA

    Wael AlJaroudi MD

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  1. Wael AlJaroudi MD
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  2. Wael A. Jaber MD
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  3. Manuel D. Cerqueira MD
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Correspondence to Wael AlJaroudi MD.

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AlJaroudi, W., Jaber, W.A. & Cerqueira, M.D. Effect of tracer dose on left ventricular mechanical dyssynchrony indices by phase analysis of gated single photon emission computed tomography myocardial perfusion imaging. J. Nucl. Cardiol. 19, 63–72 (2012). https://doi.org/10.1007/s12350-011-9463-z

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  • DOI: https://doi.org/10.1007/s12350-011-9463-z

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