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Journal of Nuclear Cardiology

Erschienen in:

08.09.2020 | Editorial

Left ventricular regional asynchrony: Earliest marker for ischemic cardiomyopathy?

verfasst von: Aviral Vij, MD, Saurabh Malhotra, MD, MPH, FASNC

Erschienen in: Journal of Nuclear Cardiology | Ausgabe 3/2021

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Left ventricular asynchrony (LVAS) refers to abnormal myocardial activation during a cardiac cycle resulting in non-homogeneous left ventricular contraction. Phase analysis of gated radionuclide tomography is an established technique to assess global and segmental LVAS.1,2 Two validated indices of LVAS include: histogram band width (HBW) which is the range (in degrees) during which 95% of the myocardium initiates contraction and phase standard deviation (PSD) which is the standard deviation (in degrees) of the timing of contraction of all the myocardial samples.3 LVAS is common in patients with heart failure and has been established as a prognostic marker of adverse outcomes.4 LVAS has the ability to predict clinical response to cardiac resynchronization therapy,5,6 and also predicts the risk of ventricular arrhythmias in patients with heart failure.7 Recent reports have assessed the diagnostic value of LVAS for predicting coronary artery disease (CAD) and associated myocardial hypoperfusion. Chen et al reported stress-induced myocardial ischemia to be associated with early post-stress LVAS on gated rest/dipyridamole Thallium-201 SPECT.8 Huang et al further showed an incremental value of stress-induced LVAS on gated SPECT, to standard visual interpretation of myocardial perfusion. In their study the extent of LVAS was related to extent of epicardial coronary artery disease.9 Additional studies have shown an improvement in LVAS with medical therapy10 and with revascularization.11 These observational studies provide evidence for relationship of LVAS with CAD and myocardial ischemia. Much of the experience with LVAS by phase analysis stems from gated SPECT, though extrapolation of these principles has led to application of phase analysis to gated positron emission tomography (PET).12 PET offers better spatial resolution, allows for list-mode acquisition, along with the assessment of myocardial blood flow. Real time imaging, immediately after vasodilator administration (as opposed to SPECT, where imaging is performed 45-60 minutes after the vasodilator injection) allows for the determination of both rest and stress function and thus rest and stress LVAS. …

Boogers MJ, Chen J, Veltman CE, van Bommel RJ, Mooyaart EAQ, Al Younis I, et al. Left ventricular diastolic dyssynchrony assessed with phase analysis of gated myocardial perfusion SPECT: Acomparison with tissue Doppler imaging. Eur J Nucl Med Mol Imaging 2011;38:2031-9. https://doi.org/10.1007/s00259-011-1870-5.CrossRefPubMedPubMedCentral

Chen J, Garcia EV, Bax JJ, Iskandrian AE, Borges-Neto S, Soman P. SPECT myocardial perfusion imaging for the assessment of left ventricular mechanical dyssynchrony. J Nucl Cardiol 2011;18:685-94. https://doi.org/10.1007/s12350-011-9392-x.CrossRefPubMedPubMedCentral

Chen J, Garcia EV, Folks RD, Cooke CD, Faber TL, Tauxe EL, et al. Onset of left ventricular mechanical contraction as determined by phase analysis of ECG-gated myocardial perfusion SPECT imaging: Development of a diagnostic tool for assessment of cardiac mechanical dyssynchrony. J Nucl Cardiol. 2005;12:687-95. https://doi.org/10.1016/j.nuclcard.2005.06.088.CrossRefPubMed

Aljaroudi WA, Hage FG, Hermann D, Doppalapudi H, Venkataraman R, Heo J, et al. Relation of left-ventricular dyssynchrony by phase analysis of gated SPECT images and cardiovascular events in patients with implantable cardiac defibrillators. J Nucl Cardiol 2010;17:398-404. https://doi.org/10.1007/s12350-009-9169-7.CrossRefPubMed

Azizian N, Rastgou F, Ghaedian T, Golabchi A, Bahadorian B, Khanlarzadeh V, et al.LV dyssynchrony assessed with phase analysis on gated myocardial perfusion SPECT can predict response to crt in patients with end-stage heart failure. Res Cardiovasc Med. 2014;3:e20720. https://doi.org/10.5812/cardiovascmed.20720.CrossRefPubMedPubMedCentral

Henneman MM, Chen J, Dibbets-Schneider P, Stokkel MP, Bleeker GB, Ypenburg C, et al. Can LV dyssynchrony as assessed with phase analysis on gated myocardial perfusion SPECT predict response to CRT? J Nucl Med 2007;48:1104-11. https://doi.org/10.2967/jnumed.107.039925.CrossRefPubMed

Malhotra S, Pasupula DK, Sharma RK, Saba S, Soman P. Relationship between left ventricular dyssynchrony and scar burden in the genesis of ventricular tachyarrhythmia. J Nucl Cardiol 2018;25:555-69. https://doi.org/10.1007/s12350-017-1095-5.CrossRefPubMed

Chen C-C, Shen T-Y, Chang M-C, Hung G-U, Chen W-C, Kao C-H, et al. Stress-induced myocardial ischemia is associated with early post-stress left ventricular mechanical dyssynchrony as assessed by phase analysis of 201Tl gated SPECT myocardial perfusion imaging. Eur J Nucl Med Mol Imaging 2012;39:1904-9. https://doi.org/10.1007/s00259-012-2208-7.CrossRefPubMedPubMedCentral

Huang W-S, Huang C-H, Lee C-L, Chen C-P, Hung G-U, Chen J. Relation of early post-stress left ventricular dyssynchrony and the extent of angiographic coronary artery disease. J Nucl Cardiol 2014;21:1048–56. https://doi.org/10.1007/s12350-014-9980-7.CrossRefPubMed

10.

Venkataraman R, Chen J, Garcia EV, Belardinelli L, Hage FG, Heo J, et al. Effect of ranolazine on left ventricular dyssynchrony in patients with coronary artery disease. Am J Cardiol 2012;110:1440-5. https://doi.org/10.1016/j.amjcard.2012.06.055.CrossRefPubMedPubMedCentral

11.

Malhotra S, Soman P. Assessment of cardiac dyssynchrony using radionuclide imaging: Performance and outcomes. In: Hage F, editor. Myocardial Perfusion Imaging (MPI): Performance, Potential Risks and Outcomes Nova Medicine and Health; 2018.

12.

Juarez-Orozco LE, Monroy-Gonzalez A, Prakken NHJ, Noordzij W, Knuuti J, deKemp RA, et al. Phase analysis of gated PET in the evaluation of mechanical ventricular synchrony: A narrative overview. J Nucl Cardiol 2019;26:1904-13. https://doi.org/10.1007/s12350-019-01670-7.CrossRefPubMedPubMedCentral

13.

Van Tosh A, Votaw JR, Cooke CD, Reichek N, Palestro CJ, Nichols KJ. Relationships between left ventricular asynchrony and myocardial blood flow. J Nucl Cardiol 2017;24:43-52. https://doi.org/10.1007/s12350-015-0270-9.CrossRefPubMed

14.

Van Tosh A, Votaw JR, Cooke CD, Cao JJ, Palestro CJ, Nichols KJ. Early onset of left ventricular regional asynchrony in arteries with sub-clinical stenosis. J Nucl Cardiol 2020. https://doi.org/10.1007/s12350-020-02251-9.CrossRefPubMed

15.

Malhotra S, Canty JM Jr. Vasodilator stress and left ventricular asynchrony. J Nucl Cardiol 2017;24:53-6. https://doi.org/10.1007/s12350-015-0292-3.CrossRefPubMed

16.

Malhotra S, Pasupula DK, Khann M, Soman P. Is left bundle branch block related to the mechanism of left ventricular dyssynchrony? J Am Coll Cardiol 2014;63:A1121. https://doi.org/10.1016/S0735-1097(14)61121-9.CrossRef

17.

Trimble MA, Borges-Neto S, Honeycutt EF, Shaw LK, Pagnanelli R, Chen J, et al. Evaluation of mechanical dyssynchrony and myocardial perfusion using phase analysis of gated SPECT imaging in patients with left ventricular dysfunction. J Nucl Cardiol 2008;15:663-70. https://doi.org/10.1016/j.nuclcard.2008.06.007.CrossRefPubMedPubMedCentral

18.

Cooke CD, Esteves FP, Chen J, Garcia EV. Left ventricular mechanical synchrony from stress and rest 82Rb PET myocardial perfusion ECG-gated studies: differentiating normal from LBBB patients. J Nucl Cardiol 2011;18:1076-85. https://doi.org/10.1007/s12350-011-9455-z.CrossRefPubMedPubMedCentral

19.

Galt JR, Garcia EV, Robbins WL. Effects of myocardial wall thickness on SPECT quantification. IEEE Trans Med Imaging 1990;9:144-50. https://doi.org/10.1109/42.56338.CrossRefPubMed

20.

Gupta K, Bajaj NS, Hage FG, Bhambhvani P. Myocardial perfusion artifacts in left bundle branch block: A diagnostic challenge. J Nucl Cardiol 2019. https://doi.org/10.1007/s12350-019-01717-9.CrossRefPubMed

Titel: Left ventricular regional asynchrony: Earliest marker for ischemic cardiomyopathy?
verfasst von: Aviral Vij, MD
Saurabh Malhotra, MD, MPH, FASNC
Publikationsdatum: 08.09.2020
Verlag: Springer International Publishing
Erschienen in: Journal of Nuclear Cardiology / Ausgabe 3/2021
Print ISSN: 1071-3581
Elektronische ISSN: 1532-6551
DOI: https://doi.org/10.1007/s12350-020-02355-2

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