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Long-term prognostic value of left ventricular dyssynchrony assessment by phase analysis from myocardial perfusion
Aju P Pazhenkottil1, Ronny R Buechel, Lars Husmann
1Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, CH-8091 Zurich, Switzerland. pak@usz.ch
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.
