Determination of the prevalence of left ventricular dyssynchrony in individuals undergoing gated SPECT myocardial perfusion imaging using phase analysis

Abstract: Left ventricular synchrony is very determining in heart performance. It is noteworthy to say that LVD is not necessarily the sign of heart malfunction. Individuals at a higher risk of developing heart failure (HF) can be identified by LVD. Gated myocardial perfusion SPECT (MPS) allows the simultaneous assessment of left ventricular (LV) perfusion, function, and mechanical dyssynchrony using phase analysis. The aim of this study was to evaluate the prevalence and predictors of LVD in patients undergoing MPI. 907 consecutive patients referred to nuclear medicine department of Farshchian heart hospital (located in Hamadan city) for diagnostic purposes were examined. They underwent Gated SPECT myocardial perfusion imaging with stress and rest two-day protocol. The Auto-Quant software package was used to evaluate perfusion, function and PA. Also significant LVD was assessed based on the following criteria: standard deviation of LV phase distribution> 19.6 and phase histogram > 72.5 in the stress phase of the examination. Several variables were evaluated using univariate and multivariate analyses. The variables significantly associated with LVD were sex (male here), obesity, hypertension, diabetes, QRS > 120 ms, history of coronary artery disease, myocardial perfusion defects reported on MPI and left ventricular dysfunction. Our study suggested that prevalence of significant LVD as a predictor of adverse cardiovascular events, death, and progression to heart failure was 12.9%. Multivariate analysis revealed that variables such obesity, diabetes, hypertension, sex (male here), coronary artery disease (CAD) and QRS > 120 mS are most associated with LVD.

Keywords:

Left Ventricular Dyssynchrony , MPI , Heart Failure , Phase Analysis