Assessment of left ventricular dyssynchrony during development of heart failure by a novel program using ECG-gated myocardial perfusion SPECT

Circ J. 2008 Mar;72(3):370-7. doi: 10.1253/circj.72.370.

Abstract

Background: A novel program, "cardioGRAF", has been developed to analyze regional left ventricular (LV) systolic/diastolic function and dyssynchrony, so the present study aimed to use it confirm the presence of LV dyssynchrony, and to correlate LV function and dyssynchrony with plasma B-type natriuretic peptide (BNP) levels during the early to advanced stages of heart failure (HF).

Methods and results: Fourteen control subjects (G-C) and 50 patients (New York Heart Association functional class I: G-1, 21 patients; class II: G-2, 15 patients; and class III: G-3, 14 patients) were examined by ECG-gated myocardial perfusion single-photon emission computed tomography, using the new index of dyssynchrony, maximal difference (MD), which is the difference between the earliest and latest temporal parameters among 17 segments. First-third filling rate (FR) and the MD of time to peak FR revealing diastolic dyssynchrony were significantly different between G-C subjects and G-1 patients. Ejection fraction, peak ejection rate, peak FR, MD of time to end-systole, and MD of time to peak ejection rate were significantly correlated with plasma BNP levels.

Conclusion: Diastolic dyssynchrony was demonstrated even in the early stage of HF, but, although not correlated with the plasma BNP level, systolic dyssynchrony might affect it.

MeSH terms

  • Aged
  • Aging / blood
  • Aging / physiology
  • Blood Pressure / physiology
  • Case-Control Studies
  • Electrocardiography / methods*
  • Female
  • Heart Failure / blood
  • Heart Failure / diagnostic imaging*
  • Heart Failure / physiopathology*
  • Heart Rate / physiology
  • Humans
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood
  • Reproducibility of Results
  • Stroke Volume / physiology
  • Technetium Tc 99m Sestamibi
  • Tomography, Emission-Computed, Single-Photon / methods*
  • Ventricular Dysfunction, Left / blood
  • Ventricular Dysfunction, Left / diagnostic imaging*
  • Ventricular Dysfunction, Left / physiopathology*

Substances

  • Natriuretic Peptide, Brain
  • Technetium Tc 99m Sestamibi