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The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2021 Dec 09

DOI: 10.23736/S1824-4785.21.03398-7

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Assessment of left ventricular function with gated myocardial perfusion SPECT and gated myocardial FDG PET in patients with left ventricular mechanical dyssynchrony

Frank P. GRANER 1, Maximilian FISCHER 2, Harun ILHAN 1, Peter BARTENSTEIN 1, Andrei TODICA 1, Sebastian LEHNER 1, 3

1 Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany; 2 Department of Internal Medicine, Cardiology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany; 3 Ambulatory Health Care Center Dr. Neumaier & Colleagues, Radiology, Nuclear Medicine, Radiation Therapy, Regensburg, Germany


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BACKGROUND: Left ventricular mechanical dyssynchrony (LVMD) and left ventricular function are intertwined. Gated myocardial perfusion SPECT (MPS) and gated fluorodeoxyglucose positron emission computed tomography (FDG PET) are an elegant way for repeated assessment of myocardial dyssynchrony and myocardial function. To the knowledge of the authors at the time this manuscript was prepared, there was no comprehensive evaluation of the interplay of LVMD and left ventricular function as measured by gated MPS and gated FDG PET; as well as no evaluation of the agreement between the two methods.
METHODS: Patients were assigned to the reference cohort (RC) and the dyssynchrony cohort (DC) based on the phase analysis results of gated MPS datasets. Subsequently left ventricular function was analyzed.
RESULTS: We demonstrated that LVMD as detected by gated MPS is associated with a significantly higher enddiastolic volume (EDV) and endsytolic volume (ESV) as well as a significantly reduced left ventricular ejection fraction (LVEF) both in gated MPS and gated FDG PET imaging. In the RC and the DC SPECT and PET showed good agreement and generally high linear correlations with regard to left ventricular volumes and LVEF. In the combined cohort (RC and DC) increasing amounts of LVMD were associated with increasing left ventricular volumes as well as a decreasing LVEF. The association was strongest for the dyssynchrony parameter Entropy.
CONCLUSIONS: We demonstrated that gated SPECT and gated PET are useful tools in the evaluation of left ventricular function in patients with LVMD as detected by gated MPS. Increasing amounts of dyssynchrony were associated with an increasingly reduced myocardial function. For repeated measurements or therapy monitoring, the methods should not be used interchangeably.


KEY WORDS: Left ventricular mechanical dyssynchrony; QGS; Phase analysis; Dyssynchrony; Left ventricular function

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