title: Cut-off values of myocardial perfusion gated-SPECT phase analysis parameters of normal subjects, and conduction and mechanical cardiac diseases.
abstract: BACKGROUND
  The aim of this study was to determine the cut-off values of gated myocardial perfusion rest SPECT phase analysis parameters of normal subjects, and conduction (CCD) and mechanical cardiac diseases (MCD).
  
  
  METHODS
  We prospectively analyzed 455 patients by means of phase analysis using SyncTool™ (Emory Cardiac Toolbox™). Of these, 150 corresponded to the control group (group 1, normal subjects) and 305 corresponded to patients with cardiac diseases (group 2, 63 with only CCD, 121 with only MCD, and 121 with CCD plus MCD). The optimal cut-off (CO) values of the peak phase (P), standard deviation (SD), bandwidth (B), skewness (S), and kurtosis (K) for discriminating between normal and dyssynchrony were obtained.
  
  
  RESULTS
  In order to differentiate group 1 from group 2, CO of SD > 18.4 and CO of B > 51 were the most sensitive parameters (75.7%, 95% CI 70.5%-80.4%, and 78.7%, 95% CI 73.7%-83.1%, respectively), and CO of S ≤ 3.2 and CO of K ≤ 9.3 were the most specific (92%, 95% CI 86.4%-95.8%, and 94.7%, 95% CI 89.8%-97.7%, respectively). In order to differentiate patients with CCD and MCD, CO values were SD > 26.1, B > 70, S ≤ 2.89, and K ≤ 10.2. In order to differentiate between patients with (n: 26) and without (n: 216) criteria of cardiac resynchronization therapy, CO values were SD > 40.2, B > 132, S ≤ 2.3, and K ≤ 4.6.
  
  
  CONCLUSIONS
  In this pilot study, different CO values of phase histogram parameters were observed between normal subjects and patients with conduction and MCD, and between patients with and without criteria of cardiac resynchronization therapy.
authors.affiliation: Cardiology Department, Hospital Universitari Vall d'Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain. guirom@telefonica.net.|Department of Nuclear Medicine, Hospital Universitari Vall d'Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain. guirom@telefonica.net.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Romero-Farina
authors.affiliation: Department of Nuclear Medicine, Hospital Universitari Vall d'Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Aguadé-Bruix
authors.affiliation: Cardiology Department, Hospital Universitari Vall d'Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Candell-Riera
authors.affiliation: Cardiology Department, Hospital Universitari Vall d'Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: María N
authors.initials: MN
authors.lastname: Pizzi
authors.affiliation: Cardiology Department, Hospital Universitari Vall d'Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: García-Dorado
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging*; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D015588:Observer Variation; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*
keywords: Left ventricular dyssynchrony; cut-off values; gated-SPECT myocardial perfusion imaging; phase analysis