Assessment of left ventricular dyssynchrony during development of heart failure by a novel program using ECG-gated myocardial perfusion SPECT.
BACKGROUND
A novel program, "cardioGRAF", has been developed to analyze regional left ventricular (LV) systolic/diastolic function and dyssynchrony, so the present study aimed to use it confirm the presence of LV dyssynchrony, and to correlate LV function and dyssynchrony with plasma B-type natriuretic peptide (BNP) levels during the early to advanced stages of heart failure (HF).


RESULTS
Fourteen control subjects (G-C) and 50 patients (New York Heart Association functional class I: G-1, 21 patients; class II: G-2, 15 patients; and class III: G-3, 14 patients) were examined by ECG-gated myocardial perfusion single-photon emission computed tomography, using the new index of dyssynchrony, maximal difference (MD), which is the difference between the earliest and latest temporal parameters among 17 segments. First-third filling rate (FR) and the MD of time to peak FR revealing diastolic dyssynchrony were significantly different between G-C subjects and G-1 patients. Ejection fraction, peak ejection rate, peak FR, MD of time to end-systole, and MD of time to peak ejection rate were significantly correlated with plasma BNP levels.


CONCLUSIONS
Diastolic dyssynchrony was demonstrated even in the early stage of HF, but, although not correlated with the plasma BNP level, systolic dyssynchrony might affect it.
Takahashi
Naoto
N
Department of Internal Medicine, Nippon Medical School, Musashikosugi Hospital, Kawasaki, Japan. yukkie@nms.ac.jp
Yamamoto
Akira
A
Tezuka
Shingo
S
Ishikawa
Masahiro
M
Abe
Junko
J
Amitani
Kenichi
K
Yamaguchi
Tomoyoshi
T
Kawaguchi
Naomi
N
Uchida
Takahiro
T
Iwahara
Shinichiro
S
Munakata
Kazuo
K
D000368:Aged; D000375:Aging / Q000097:blood / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D016022:Case-Control Studies; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D015203:Reproducibility of Results; D013318:Stroke Volume / Q000502:physiology; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000000981:diagnostic imaging* / Q000503:physiopathology*
D020097:Natriuretic Peptide, Brain; D017256:Technetium Tc 99m Sestamibi