Relationship between left ventricular function and wall motion synchrony in heart failure assessed by ECG-gated myocardial perfusion SPECT.
OBJECTIVE
To confirm the relationship between left ventricular (LV) function and wall motion synchrony, and to identify the difference of synchrony between an ischemic heart disease (IHD) patient group and other heart disease (OHD) patient group among classified groups in heart failure, systolic, and diastolic parameters were compared using electrocardiograph-gated single-photon emission computed tomography.


RESULTS
Twenty IHD and 30 OHD patient groups, comprised New York Heart Association functional class I-III (IHD1-3 and OHD1-3), and 15 controls were examined. The LV functions (ejection fraction, EF; peak-filling rate, PFR) and synchrony, which was estimated from the time lag between the earliest and latest regional systolic or diastolic temporal parameters (maximum difference of regional time to end-systole, MD-TES, or maximum difference of regional time to peak filling, MD-TPF), were compared. The LV function correlated with its synchrony in IHD and OHD (EF vs. MD-TES: r = -0.86, P = 1.3 x 10(-6) in IHD and r = -0.69, P = 2.8 x 10(-5) in OHD. PFR versus MD-TPF: r = -0.67, P < 0.002 in IHD and r = -0.63, P < 0.0002 in OHD). Dyssynchronous normal EF was observed in three IHD (15%) and six OHD (20%). Dyssynchronous normal PFR was observed in six IHD (30%) and six OHD (20%). MD-TES was significantly smaller in control group (CG) than in IHD3 and OHD3 (P < 0.005), and in IHD1 than in IHD3 and OHD3 (P < 0.05). MD-TPF was significantly smaller in CG than in IHD2, IHD3, and OHD3 (P < 0.05). However, there was no significant difference between LV synchrony in IHD and OHD, or among LV synchrony of the same functional classes between these two groups.


CONCLUSIONS
This study confirms that LV function is correlated with wall motion synchrony. No statistically significant difference was confirmed in wall motion synchrony between IHD and OHD. However, dyssynchrony appears in the patients without apparent global LV dysfunction. This feature may facilitate identification of synchronous disorder in HF patients with preserved global LV function. It is expected that detection of such a disorder may lead to the initiation of appropriate treatments for early stage HF and prevent its progression.
Yamamoto
Akira
A
Department of Radiology, Nippon Medical School, Tamanagayama Hospital, 1-7-1 Nagayama, Tama, Tokyo, 206-8512, Japan. a-yamato@ra2.so-net.ne.jp
Takahashi
Naoto
N
Ishikawa
Masahiro
M
Abe
Kazuya
K
Kobayashi
Yuko
Y
Tamai
Jin
J
Munakata
Kazuo
K
D000368:Aged; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D015637:Gated Blood-Pool Imaging / Q000379:methods*; D006333:Heart Failure / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging*