title: Left ventricular diastolic dyssynchrony assessed with phase analysis of gated myocardial perfusion SPECT: a comparison with tissue Doppler imaging.
abstract: OBJECTIVE
  The aim of the current study was to evaluate the feasibility of phase analysis on gated myocardial perfusion SPECT (GMPS) for the assessment of left ventricular (LV) diastolic dyssynchrony in a head-to-head comparison with tissue Doppler imaging (TDI).
  
  
  METHODS
  The population consisted of patients with end-stage heart failure of New York Heart Association functional class III or IV with a reduced LV ejection fraction of ≤ 35%. LV diastolic dyssynchrony was calculated using TDI as the maximal time delay between early peak diastolic velocities of two opposing left ventricle walls (diastolic mechanical delay). Significant LV diastolic dyssynchrony was defined as a diastolic mechanical delay of >55 ms on TDI. Furthermore, phase analysis on GMPS was performed to evaluate LV diastolic dyssynchrony; diastolic phase standard deviation (SD) and histogram bandwidth (HBW) were used as markers of LV diastolic dyssynchrony.
  
  
  RESULTS
  A total of 150 patients (114 men, mean age 66.0 ± 10.4 years) with end-stage heart failure were enrolled. Both diastolic phase SD (r = 0.81, p < 0.01) and diastolic HBW (r = 0.75, p < 0.01) showed good correlations with LV diastolic dyssynchrony on TDI. Additionally, patients with LV diastolic dyssynchrony on TDI (>55 ms) showed significantly larger diastolic phase SD (68.1 ± 13.4° vs. 40.7 ± 14.0°, p < 0.01) and diastolic HBW (230.6 ± 54.3° vs. 129.0 ± 55.6°, p < 0.01) as compared to patients without LV diastolic dyssynchrony on TDI (≤ 55 ms). Finally, phase analysis on GMPS showed a good intra- and interobserver reproducibility for the determination of diastolic phase SD (ICC 0.97 and 0.88) and diastolic HBW (ICC 0.98 and 0.93).
  
  
  CONCLUSIONS
  Phase analysis on GMPS showed good correlations with TDI for the assessment of LV diastolic dyssynchrony.
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA, The Netherlands.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Boogers
authors.forename: Ji
authors.initials: J
authors.lastname: Chen
authors.forename: Caroline E
authors.initials: CE
authors.lastname: Veltman
authors.forename: Rutger J
authors.initials: RJ
authors.lastname: van Bommel
authors.forename: Eline A Q
authors.initials: EA
authors.lastname: Mooyaart
authors.forename: Imad
authors.initials: I
authors.lastname: Al Younis
authors.forename: Bernies
authors.initials: B
authors.lastname: van der Hiel
authors.forename: Petra
authors.initials: P
authors.lastname: Dibbets-Schneider
authors.forename: Ernst E
authors.initials: EE
authors.lastname: van der Wall
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Schalij
authors.forename: Ernest V
authors.initials: EV
authors.lastname: Garcia
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
authors.forename: Victoria
authors.initials: V
authors.lastname: Delgado
mesh_terms: D000368:Aged; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography; D003971:Diastole / Q000502:physiology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D055414:Myocardial Perfusion Imaging; D012189:Retrospective Studies; D013599:Systole / Q000502:physiology; D018608:Ultrasonography, Doppler; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000473:pathology