title: Phase analysis of gated myocardial perfusion single-photon emission computed tomography compared with tissue Doppler imaging for the assessment of left ventricular dyssynchrony.
abstract: OBJECTIVE
  The purpose of this study was to compare left ventricular (LV) dyssynchrony assessment by gated myocardial perfusion single-photon emission computed tomography (SPECT) (GMPS) and tissue Doppler imaging (TDI).
  
  
  BACKGROUND
  Recently, it has been suggested that LV dyssynchrony is an important predictor of response to cardiac resynchronization therapy (CRT); dyssynchrony is predominantly assessed by TDI with echocardiography. Information on LV dyssynchrony can also be provided by GMPS with phase analysis of regional LV maximal count changes throughout the cardiac cycle, which tracks the onset of LV thickening.
  
  
  METHODS
  In 75 patients with heart failure, depressed LV function, and wide QRS complex, GMPS and 2-dimensional echocardiography, including TDI, were performed as part of clinical screening for eligibility for CRT. Clinical status was evaluated with New York Heart Association functional classification, 6-min walk distance, and quality-of-life score. Different parameters (histogram bandwidth, phase SD, histogram skewness, and histogram kurtosis) of LV dyssynchrony were assessed from GMPS and compared with LV dyssynchrony on TDI with Pearson's correlation analyses.
  
  
  RESULTS
  Histogram bandwidth and phase SD correlated well with LV dyssynchrony assessed with TDI (r = 0.89, p < 0.0001 and r = 0.80, p < 0.0001, respectively). Histogram skewness and kurtosis correlated less well with LV dyssynchrony on TDI (r = -0.52, p < 0.0001 and r = -0.45, p < 0.0001, respectively).
  
  
  CONCLUSIONS
  The LV dyssynchrony assessed from GMPS correlated well with dyssynchrony assessed by TDI; histogram bandwidth and phase SD showed the best correlation with LV dyssynchrony on TDI. These parameters seem most optimal for assessment of LV dyssynchrony with gated SPECT. Outcome studies after CRT are needed to further validate the use of GMPS for assessment of LV dyssynchrony.
authors: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
authors: Maureen M
authors: MM
authors: Henneman
authors: Ji
authors: J
authors: Chen
authors: Claudia
authors: C
authors: Ypenburg
authors: Petra
authors: P
authors: Dibbets
authors: Gabe B
authors: GB
authors: Bleeker
authors: Eric
authors: E
authors: Boersma
authors: Marcel P
authors: MP
authors: Stokkel
authors: Ernst E
authors: EE
authors: van der Wall
authors: Ernest V
authors: EV
authors: Garcia
authors: Jeroen J
authors: JJ
authors: Bax
mesh_terms: D000368:Aged; D002303:Cardiac Output, Low / Q000628:therapy; D002304:Cardiac Pacing, Artificial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon; D018608:Ultrasonography, Doppler; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*