Left-ventricular systolic and diastolic dyssynchrony as assessed by multi-harmonic phase analysis of gated SPECT myocardial perfusion imaging in patients with end-stage renal disease and normal LVEF

• Type of Material: Article
• Authors: Ji Chen, Emory University; Andreas Kalogeropoulos, Emory University; Liudmila Verdes, Emory University; Javed Butler, Emory University; Ernest V Garcia, Emory University
• Language: English
• Date: 2011-04
• Publisher: Springer Verlag (Germany)
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2011 American Society of Nuclear Cardiology.
• Final Published Version (URL): http://link.springer.com/article/10.1007%2Fs12350-010-9331-2
• Title of Journal or Parent Work: Journal of Nuclear Cardiology
• ISSN: 1071-3581
• Volume: 18
• Issue: 2
• Start Page: 299
• End Page: 308
• Grant/Funding Information: This study was supported in part by an NIH Grant (1R01HL094438; PI: Ji Chen, PhD).
• Keywords: gated SPECT; Systolic dyssynchrony; myocardial perfusion imaging; end-stage renal disease; diastolic dyssynchrony
• Research Categories: Health Sciences, Radiology; Health Sciences, Medicine and Surgery

Abstract

Background The purpose of this study was to develop a multi-harmonic phase analysis method to measure diastolic dyssynchrony from conventional gated SPECT myocardial perfusion imaging(MPI) data and to compare it with systolic dyssynchrony in normal subjects and in patients with end-stage renal disease (ESRD) and normal left-ventricular ejection fraction (LVEF). Methods 121 consecutive patients with ESRD and normal LVEF and 30 consecutive normal controls were enrolled. Diastolic dyssynchrony parameters were calculated using 3-harmonic phase analysis. Systolic dyssynchrony parameters were calculated using the established 1-harmonic phase analysis. Results The systolic and diastolic dyssynchrony parameters were correlated, but significantly different in both control and ESRD groups, indicating they were physiologically related but measured different LV mechanisms. The systolic and diastolic dyssynchrony parameters were each significantly different between the control and the ESRD groups. Significant systolic and diastolic dyssynchrony were found in 47% and 65% of the entire ESRD group. Conclusion Multi-harmonic phase analysis has been developed to assess diastolic dyssynchrony, which measured a new LV mechanism of regional function from gated SPECT MPI and showed a significantly higher prevalence rate than systolic dyssynchrony in patients with ESRD and normal LVEF.