Long-term prognostic value of left ventricular dyssynchrony assessment by phase analysis from myocardial perfusion imaging.
OBJECTIVE
To assess the value of left ventricular (LV) dyssynchrony, using phase analysis of nuclear single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) as independent predictor of cardiac events.


METHODS
Phase analysis using Emory Cardiac Toolbox was applied on gated rest MPI scans to assess LV dyssynchrony in a total of 202 patients. Follow-up was obtained in 197 patients (97.5%). Major adverse cardiac events (MACE) (cardiac death and hospitalisation for any cardiac reasons, including worsening of heart failure, non-fatal myocardial infarction, unstable angina and coronary revascularisation) were determined using the Kaplan-Meier method. Cox proportional hazard regression was used to identify independent predictors of cardiac events.


RESULTS
At a median follow-up of 3.2 ± 1.2 years, 41 patients had at least one event, including 5 cardiac deaths. LV dyssynchrony (n = 35) was associated with a significantly higher incidence of MACE (p<0.001) and proved to be an independent predictor of cardiac events.


CONCLUSIONS
LV dyssynchrony assessed by phase analysis of gated SPECT-MPI is a strong predictor of MACE independent of other known predictors such as perfusion defects or decreased LV ejection fraction.
Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, CH-8091 Zurich, Switzerland. pak@usz.ch
Aju P
AP
Pazhenkottil
Ronny R
RR
Buechel
Lars
L
Husmann
René N
RN
Nkoulou
Mathias
M
Wolfrum
Jelena-Rima
JR
Ghadri
Janine
J
Kummer
Bernhard A
BA
Herzog
Philipp A
PA
Kaufmann
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / Q000379:methods* / Q000401:mortality; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D042241:Early Diagnosis; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D011379:Prognosis; D012016:Reference Values; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000401:mortality