Improvement of Left Ventricular Asynchrony: Cases of Functional Recovery After Revascularization

Cardiovasc Eng Technol. 2015 Mar;6(1):19-24. doi: 10.1007/s13239-014-0200-z. Epub 2014 Nov 5.

Abstract

Assessment of regional contraction is considered important for diagnosis of coronary artery disease (CAD). We evaluated the synchronicity in regional contraction and assessed recovery from contraction insufficiency after revascularizations. Myocardial contraction parallel to the left ventricular (LV) wall was calculated using the method called quantification of segmental function by solving the Poisson equation (QSFP) from an electrocardiogram (ECG)-gated (99m)Tc-methoxyisobutylisonitrile (MIBI) single-photon emission computed tomographic (ECG-SPECT) image. Myocardial synchronous contraction was quantified using the synchronous contraction index (SCI), defined as the temporal correlation coefficient between LV volume and regional myocardial shortening. SCI was evaluated in 20 subjects, of whom 10 had CAD and 10 were normal. ECG-SPECT was performed in all the CAD patients before and after revascularization. In the 10 patients with CAD, the mean SCI before the revascularization was 62.7 ± 19.1%, which was significantly lower than that in the normal subjects (95.0 ± 3.0%, p = 0.002). After revascularization, a significant improvement in SCI was recorded (74.8 ± 11.1%, p = 0.01). The territorial improvement in SCI was 12.0 ± 15.6% (p = 0.03). Locations of abnormal cardiac contraction due to CAD were delineated by using QSFP. Therefore, SCI can be considered a valuable index for cardiac function assessment.

Keywords: Cardiac imaging; Coronary revascularization; Left ventricular asynchrony; Nuclear medicine; Single-photon emission computed tomography.

MeSH terms

  • Aged
  • Cardiovascular Diseases / diagnostic imaging*
  • Electrocardiography / methods
  • Humans
  • Male
  • Middle Aged
  • Myocardial Contraction*
  • Technetium Tc 99m Sestamibi
  • Tomography, Emission-Computed, Single-Photon / methods
  • Ventricular Function, Left*

Substances

  • Technetium Tc 99m Sestamibi