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Long-term prognostic value of left ventricular dyssynchrony assessment by phase analysis from myocardial perfusion imaging


Pazhenkottil, A P; Buechel, R R; Husmann, L; Nkoulou, R N; Wolfrum, M; Ghadri, J R; Kummer, J; Herzog, B A; Kaufmann, P A (2011). Long-term prognostic value of left ventricular dyssynchrony assessment by phase analysis from myocardial perfusion imaging. Heart, 97(1):33-37.

Abstract

OBJECTIVE: To assess the value of left ventricular (LV) dyssynchrony, using phase analysis of nuclear single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) as independent predictor of cardiac events.
METHODS: Phase analysis using Emory Cardiac Toolbox was applied on gated rest MPI scans to assess LV dyssynchrony in a total of 202 patients. Follow-up was obtained in 197 patients (97.5%). Major adverse cardiac events (MACE) (cardiac death and hospitalisation for any cardiac reasons, including worsening of heart failure, non-fatal myocardial infarction, unstable angina and coronary revascularisation) were determined using the Kaplan-Meier method. Cox proportional hazard regression was used to identify independent predictors of cardiac events.
RESULTS: At a median follow-up of 3.2 ± 1.2 years, 41 patients had at least one event, including 5 cardiac deaths. LV dyssynchrony (n = 35) was associated with a significantly higher incidence of MACE (p<0.001) and proved to be an independent predictor of cardiac events.
CONCLUSION: LV dyssynchrony assessed by phase analysis of gated SPECT-MPI is a strong predictor of MACE independent of other known predictors such as perfusion defects or decreased LV ejection fraction.

OBJECTIVE: To assess the value of left ventricular (LV) dyssynchrony, using phase analysis of nuclear single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) as independent predictor of cardiac events.
METHODS: Phase analysis using Emory Cardiac Toolbox was applied on gated rest MPI scans to assess LV dyssynchrony in a total of 202 patients. Follow-up was obtained in 197 patients (97.5%). Major adverse cardiac events (MACE) (cardiac death and hospitalisation for any cardiac reasons, including worsening of heart failure, non-fatal myocardial infarction, unstable angina and coronary revascularisation) were determined using the Kaplan-Meier method. Cox proportional hazard regression was used to identify independent predictors of cardiac events.
RESULTS: At a median follow-up of 3.2 ± 1.2 years, 41 patients had at least one event, including 5 cardiac deaths. LV dyssynchrony (n = 35) was associated with a significantly higher incidence of MACE (p<0.001) and proved to be an independent predictor of cardiac events.
CONCLUSION: LV dyssynchrony assessed by phase analysis of gated SPECT-MPI is a strong predictor of MACE independent of other known predictors such as perfusion defects or decreased LV ejection fraction.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
04 Faculty of Medicine > Center for Integrative Human Physiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Nuclear Medicine
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Language:English
Date:2011
Deposited On:11 Feb 2011 08:29
Last Modified:05 Apr 2016 14:41
Publisher:BMJ Publishing Group
ISSN:1355-6037
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:10.1136/hrt.2010.201566
PubMed ID:20962345
Permanent URL: http://doi.org/10.5167/uzh-44151

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