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Assessment of cardiac function in patients with heart disease by quantitative gated myocardial perfusion SPECT
Ichiro Nakae1, Shinro Matsuo, Takayoshi Tsutamoto
1Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Seta, Otsu 520-2192, Japan. nakae@belle.shiga-med.ac.jp
Insights
Cardiovascular stiffness, indicated by brachial-ankle pulse wave velocity (baPWV), is linked to diastolic dysfunction in older adults. This finding highlights potential targets for managing heart disease in the elderly population.
Area of Science:
- Cardiology
- Nuclear Medicine
- Medical Imaging
Background:
- Assessing cardiac function is crucial for diagnosing and managing heart disease.
- Myocardial single photon emission computed tomography (SPECT) is a key imaging technique.
- Understanding the relationship between cardiac stiffness and dysfunction is important for elderly patients.
Purpose of the Study:
- To evaluate left ventricular (LV) systolic and diastolic function using Tc-99m sestamibi SPECT.
- To investigate the association between cardiovascular stiffness (measured by baPWV) and diastolic dysfunction in elderly patients.
Main Methods:
- Analyzed 16-framing Tc-99m sestamibi SPECT data in 192 patients (age >= 40) with suspected heart disease.
- Estimated LV ejection fraction (EF), first third filling fraction (1/3FF), peak filling rate (PFR), and time-to-peak filling (TPF).
- Measured brachial-ankle pulse wave velocity (baPWV) in 51 patients (age >= 60) as an indicator of arterial stiffness.
Main Results:
- Mild correlation found between diastolic parameters PFR and 1/3FF (r = 0.28, P < 0.001).
- Patients were categorized into four groups based on LV systolic (EF) and diastolic (PFR) function.
- baPWV correlated inversely with 1/3FF (r = -0.59, P < 0.001) and positively with TPF (r = 0.45, P < 0.001), indicating stiffness is linked to diastolic dysfunction, but not systolic function (EF).
Conclusions:
- Increased cardiovascular stiffness, reflected by higher baPWV, is associated with diastolic dysfunction in elderly individuals.
- These findings suggest that arterial stiffness may play a significant role in the development of diastolic dysfunction in older patients.
Objective:
We examined the cardiac function of patients who underwent Tc-99m sestamibi quantitative gated myocardial single photon emission computed tomography with 16-framing data acquisition between January 1, 2004 and March 31, 2006 for an evaluation of suspected or known heart disease in our hospital.
Methods:
In 192 patients aged >or=40 years, the left ventricular (LV) systolic function [parameter: ejection fraction (EF)] and diastolic function [first third filling fraction (1/3FF), peak filling rate (PFR), and time-to-peak filling (TPF)] were estimated by volume curve analysis. In 51 (age >or=60 years) of 192 patients, brachial-ankle pulse wave velocity (baPWV) was also measured.
Results:
The correlation between diastolic parameters PFR and 1/3FF was mild (r = 0.28, P < 0.001). On the basis of EF and PFR, 192 patients were divided into four groups: P (preserved LV function), Q (isolated systolic dysfunction, EF < 50%), R (isolated diastolic dysfunction, PFR < 1.8 EDV/s), and S (both dysfunctions). The numbers of patients in P, Q, R, and S groups were 94 (49.0%), 7 (3.6%), 31 (16.1%), and 60 (31.3%), respectively. The 1/3FF correlated weakly but significantly with age (r = -0.16, P < 0.05). The TPF also correlated weakly with age (r = 0.25, P < 0.01), but EF did not. The baPWV, an indicator of cardiovascular stiffness, correlated inversely with 1/3FF (r = -0.59, P < 0.001) or correlated positively with TPF (r = 0.45, P < 0.001), but not with EF.
Conclusions:
Our study suggests that cardiovascular stiffness associated with increased baPWV may contribute to the occurrence of diastolic dysfunction in elderly patients.
