thallium-201 and Ventricular-Dysfunction--Left

Topics: Aged; Fatty Acids; Female; Humans; Iodine Radioisotopes; Iodobenzenes; Japan; Middle Aged; Myocardial Perfusion Imaging; Nicorandil; Scleroderma, Systemic; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon; Treatment Outcome; Vasodilator Agents; Ventricular Dysfunction, Left

This study aimed to investigate whether indices of left ventricular (LV) dyssynchrony by gated myocardial perfusion SPECT (GMPS) could be useful to predict prognosis in chronic kidney disease (CKD) patients with normal perfusion defect scores.. One hundred and sixty-seven CKD patients with normal perfusion defect scores on adenosine-stress. The MACEs occurred in 12 patients (7.1%). Patients who experienced MACEs showed significantly higher PSD and wider BW than those who did not. In the Kaplan-Meier event-free survival analysis, cardiac event rate was significantly higher in the high-PSD and wide-BW group (n = 81) than in the low-PSD and narrow-BW group (n = 71) (P = .002). The multivariate regression analysis revealed that the PSD was associated with MACEs (odds ratio 1.33, 95% confidence interval 1.05-1.69, P = .01).. The LV dyssynchrony indices from GMPS may be novel prognostic predictors in CKD patients with normal perfusion defect scores.

Topics: Aged; Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography; Female; Heart Ventricles; Humans; Kidney Failure, Chronic; Male; Middle Aged; Myocardial Perfusion Imaging; Prognosis; Retrospective Studies; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon; Treatment Outcome; Ventricular Dysfunction, Left

The myocardial perfusion single photon emission computed tomography synchronized with the electrocardiogram (gated SPECT) has been widely used for the assessment of left ventricular (LV) systolic and diastolic functions using Quantitative gated SPECT. The aim of this study was to compare the effects of 8-frame and 16-frame thallium-201 (Tl-201) gated SPECT for determining LV systolic and diastolic parameters. The study population included 42 patients with suspected coronary artery disease who underwent gated SPECT by clinical indication. LV systolic and diastolic parameters were assessed on 8-frame and 16-frame gated SPECT. There were good correlations in end-diastolic volume (r = 0.99, p < 0.001), end-systolic volume (ESV) (r = 0.97, p < 0.001) and ejection fraction (EF) (r = 0.95, p < 0.001) between 8-frame and 16-frame gated SPECT. Bland-Altman plot showed a significant negative slope of -0.08 in EDV indicating a larger difference for larger EDV. Eight-frame gated SPECT overestimated ESV by 2.3 ml, and underestimated EF by -4.2% than 16-frame gated SPECT. There were good correlations in peak filling rate (PFR) (r = 0.87, p < 0.001), one third mean filling rate (r = 0.87, p < 0.001) and time to PFR (r = 0.61, p < 0.001) between 8-frame and 16-frame gated SPECT. Eight-frame gated SPECT underestimated PFR by -0.22 than 16-frame gated SPECT. Eight-frame gated SPECT estimated as much MFR/3 and TPFR as 16-frame gated SPECT. According to the data, the study suggested that 8-frame Tl-201 gated SPECT could underestimate systolic and/or diastolic parameter when compared with 16-frame gated SPECT.

Topics: Aged; Aged, 80 and over; Coronary Artery Disease; Female; Heart Ventricles; Humans; Japan; Male; Myocardial Contraction; Myocardial Perfusion Imaging; Stroke Volume; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon; Ventricular Dysfunction, Left