title: Left ventricular dyssynchrony assessed by two three-dimensional imaging modalities: phase analysis of gated myocardial perfusion SPECT and tri-plane tissue Doppler imaging.
abstract: OBJECTIVE
  To compare left ventricular (LV) dyssynchrony assessment by phase analysis from gated myocardial perfusion SPECT (GMPS) with LV dyssynchrony assessment by tri-plane tissue Doppler imaging (TDI). Baseline LV dyssynchrony assessed with standard deviation (SD) of time-to-peak systolic velocity of 12 LV segments (Ts-SD) with TDI has proven to be a powerful predictor of response to CRT. Information on LV dyssynchrony can also be provided by GMPS with phase analysis of regional LV maximal count changes throughout the cardiac cycle.
  
  
  METHODS
  Forty heart failure patients, referred for evaluation of potential eligibility for CRT, underwent both 3D echocardiography, with tri-plane TDI, and resting GMPS. From tri-plane TDI, Ts-SD was used as a validated parameter of LV dyssynchrony and compared with different indices (histogram bandwidth, phase SD, histogram skewness and kurtosis) derived from phase analysis of GMPS.
  
  
  RESULTS
  Histogram bandwidth and phase SD showed good correlation with Ts-SD (r=0.77 and r=0.74, p<0.0001, respectively). Patients with substantial LV dyssynchrony assessed with tri-plane TDI (Ts-SD >or=33 ms) had also significantly higher values of histogram bandwidth and phase SD.
  
  
  CONCLUSIONS
  The results of this study support the use of phase analysis by GMPS to evaluate LV dyssynchrony. Histogram bandwidth and phase SD showed the best correlation with Ts-SD assessed with tri-plane TDI and appeared the most optimal variables for assessment of LV dyssynchrony with GMPS.
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands.
authors.forename: Nina Ajmone
authors.initials: NA
authors.lastname: Marsan
authors.forename: Maureen M
authors.initials: MM
authors.lastname: Henneman
authors.forename: Ji
authors.initials: J
authors.lastname: Chen
authors.forename: Claudia
authors.initials: C
authors.lastname: Ypenburg
authors.forename: Petra
authors.initials: P
authors.lastname: Dibbets
authors.forename: Stefano
authors.initials: S
authors.lastname: Ghio
authors.forename: Gabe B
authors.initials: GB
authors.lastname: Bleeker
authors.forename: Marcel P
authors.initials: MP
authors.lastname: Stokkel
authors.forename: Ernst E
authors.initials: EE
authors.lastname: van der Wall
authors.forename: Luigi
authors.initials: L
authors.lastname: Tavazzi
authors.forename: Ernest V
authors.initials: EV
authors.lastname: Garcia
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
mesh_terms: D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000000981:diagnostic imaging; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007511:Ischemia / Q000150:complications; D008297:Male; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology