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Published on: December 13, 2019
Assessment of left ventricular diastolic function by gated single-photon emission tomography: comparison with Doppler
Tetsuhiro Yamano1, Tomoki Nakamura, Kenzo Sakamoto
1Second Department of Internal Medicine, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kawaramachi Hirokoji Agaru, Kamigyo-ku, 602-8566 Kyoto, Japan. tyamano@koto.kpu-m.ac.jp
Insights
Gated single-photon emission tomography (SPET) can assess left ventricular (LV) diastolic function, correlating well with Doppler echocardiography. This nuclear imaging technique offers a new tool for evaluating heart diastolic function alongside perfusion and systolic function.
Area of Science:
- Nuclear Medicine
- Cardiology
- Diagnostic Imaging
Background:
- Gated single-photon emission tomography (SPET) is not routinely used for evaluating left ventricular (LV) diastolic function.
- Doppler echocardiography is an established method for assessing diastolic function.
- Assessing LV diastolic function is crucial for understanding various cardiac conditions.
Purpose of the Study:
- To evaluate the capability of gated SPET in assessing LV diastolic function.
- To compare diastolic function parameters derived from gated SPET with those from Doppler echocardiography.
Main Methods:
- 37 patients with normal sinus rhythm underwent gated technetium-99m tetrofosmin SPET with 32 frames per R-R interval.
- Doppler transmitral flow velocity waveforms were acquired immediately before SPET.
- Exclusion criteria included E/A ratio >1 or >5% R-R interval difference between methods.
Main Results:
- Gated SPET's peak filling rate (PFR) correlated significantly with Doppler's early transmitral flow velocity (E wave) (r=0.65) and E wave deceleration (r=0.71).
- Time to PFR and percent atrial contribution to LV filling from SPET showed excellent correlation with Doppler's LV isovolumic relaxation time (r=0.93) and E/A ratio (r=-0.85).
- SPET's PFR point generally coincided with Doppler's E wave peak, indicating good temporal agreement.
Conclusions:
- Gated SPET can assess LV diastolic function, complementing its role in evaluating myocardial perfusion and systolic function.
- While SPET shows promise for diastolic function assessment, precise detection of the filling onset may have limitations.
- This study demonstrates the potential of gated SPET as a comprehensive tool for cardiac function evaluation.
Abstract:
Gated single-photon emission tomography (SPET) is not yet an established procedure for the evaluation of left ventricular (LV) diastolic function. This study examined diastolic function derived from gated SPET in comparison with an established diagnostic tool, Doppler echocardiography. We examined 37 consecutive patients with normal sinus rhythm who underwent gated technetium-99m tetrofosmin SPET. A gated SPET program was used with a temporal resolution of 32 frames per R-R interval. We obtained the Doppler transmitral flow velocity waveform immediately before gated SPET image acquisition. Patients who showed a ratio of peak early transmitral flow velocity to atrial flow velocity (E/A) of >1 or whose R-R intervals differed by >5% between Doppler echocardiography and gated SPET were excluded from this investigation. We compared diastolic indices and presumed corresponding intervals in diastole using the two methods. The peak filling rate (PFR) derived from gated SPET correlated with the Doppler peak velocity of the early transmitral flow (E) wave ( r=0.65) and deceleration of the E wave ( r=0.71). The time to PFR and percent atrial contribution to LV filling from gated SPET correlated excellently with the Doppler LV isovolumic relaxation time ( r=0.93) and the E/A ratio ( r=-0.85), respectively. There was a significant linear correlation in all the intervals from the R wave to the presumed corresponding diastolic points. The point of PFR in gated SPET and the peak of the E wave in Doppler echocardiography generally coincided. The onset of filling in gated SPET tended to be closer to the second heart sound than the start of the E wave in Doppler echocardiography. We conclude that gated SPET permits the assessment of not only myocardial perfusion and LV systolic function but also diastolic function, although there may be some errors in detection of the precise beginning of LV filling.
