title: Left-ventricular systolic and diastolic dyssynchrony as assessed by multi-harmonic phase analysis of gated SPECT myocardial perfusion imaging in patients with end-stage renal disease and normal LVEF.
abstract: BACKGROUND
  The purpose of this study was to develop a multi-harmonic phase analysis method to measure diastolic dyssynchrony from conventional gated SPECT myocardial perfusion imaging (MPI) data and to compare it with systolic dyssynchrony in normal subjects and in patients with end-stage renal disease (ESRD) and normal left-ventricular ejection fraction (LVEF).
  
  
  METHODS
  121 consecutive patients with ESRD and normal LVEF and 30 consecutive normal controls were enrolled. Diastolic dyssynchrony parameters were calculated using 3-harmonic phase analysis. Systolic dyssynchrony parameters were calculated using the established 1-harmonic phase analysis.
  
  
  RESULTS
  The systolic and diastolic dyssynchrony parameters were correlated, but significantly different in both control and ESRD groups, indicating they were physiologically related but measured different LV mechanisms. The systolic and diastolic dyssynchrony parameters were each significantly different between the control and the ESRD groups. Significant systolic and diastolic dyssynchrony were found in 47% and 65% of the entire ESRD group.
  
  
  CONCLUSIONS
  Multi-harmonic phase analysis has been developed to assess diastolic dyssynchrony, which measured a new LV mechanism of regional function from gated SPECT MPI and showed a significantly higher prevalence rate than systolic dyssynchrony in patients with ESRD and normal LVEF.
authors.affiliation: Department of Radiology, Emory University, 1364 Clifton Rd NE, Atlanta, GA 30322, USA. jchen22@emory.edu
authors.forename: Ji
authors.initials: J
authors.lastname: Chen
authors.forename: Andreas P
authors.initials: AP
authors.lastname: Kalogeropoulos
authors.forename: Liudmila
authors.initials: L
authors.lastname: Verdes
authors.forename: Javed
authors.initials: J
authors.lastname: Butler
authors.forename: Ernest V
authors.initials: EV
authors.lastname: Garcia
mesh_terms: D000328:Adult; D000368:Aged; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / Q000379:methods*; D003971:Diastole; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D013318:Stroke Volume; D013599:Systole; D016277:Ventricular Function, Left