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Ventricular systolic and diastolic rate indices in patients with either normal or low resting left ventricular
I M Hassan1, M M Mohammed, K Kouris
1Department of Nuclear Medicine, Faculty of Medicine, Kuwait University.
Insights
Right and left ventricular systolic and diastolic rate indices, including peak ejection rate (PER) and peak filling rate (PFR), show reduced values in ischaemic heart disease (IHD) patients. However, no single index proved more sensitive than left ventricular ejection fraction (LVEF) for identifying IHD.
Area of Science:
- Cardiology
- Nuclear Medicine
- Cardiovascular Imaging
Background:
- Ischaemic heart disease (IHD) diagnosis relies on accurate assessment of cardiac function.
- Left ventricular ejection fraction (LVEF) is a key indicator, but early detection in patients with preserved LVEF remains challenging.
- Ventricular systolic and diastolic rate indices may offer additional diagnostic insights.
Purpose of the Study:
- To evaluate the utility of right and left ventricular systolic and diastolic rate indices in identifying patients with ischaemic heart disease (IHD).
- To compare the sensitivity of these indices against left ventricular ejection fraction (LVEF) in IHD detection.
Main Methods:
- Gated blood-pool imaging was performed on 19 normal subjects and 56 IHD patients (divided by LVEF).
- Analysis of time-activity curves derived peak ejection rate (PER), peak filling rate (PFR), and mean filling rate (MFR).
- Comparison of these parameters between normal subjects and IHD patient groups with varying LVEF.
Main Results:
- Group 2 IHD patients (LVEF ≥ 50%) exhibited significantly reduced LV PER and PFR compared to normal subjects.
- Patients with severely depressed LVEF showed significantly lower PER and PFR.
- A considerable overlap in parameter values was observed between the groups.
Conclusions:
- While ventricular rate indices are reduced in IHD, they do not surpass LVEF sensitivity in identifying IHD patients with normal resting LVEF.
- LVEF remains a primary sensitive parameter for detecting IHD in patients with preserved systolic function.
Abstract:
To investigate the potential uses of right and left ventricular systolic and diastolic rate indices in identifying patients with ischaemic heart disease (IHD), gated blood-pool imaging was performed for 19 normal subjects (group 1) and 56 patients, of whom 31 had resting LVEF greater than or equal to 50% (group 2) and 25 had resting LVEF less than or equal to 50 (group 3). The peak ejection rate (PER) and peak filling rate (PFR), their timing and the mean filling rate (MFR) were derived from the time-activity curves analysis. Group 2 patients had significantly reduced LV PER and PFR (3.00 +/- 0.58 EDV/s, p less than 0.005, 2.29 +/- 0.54 EDV/s, p less than 0.0009) as compared to normal (3.90 +/- 0.70 EDV/s and 3.35 +/- 0.80 EDV/s respectively). Patients with profoundly depressed LVEF had significantly low PER and PFR (1.96 +/- 0.50 EDV/s, 1.46 +/- 0.27 EDV/s respectively). However, there was considerable overlap in values between groups. Therefore, we conclude that there is no single parameter more sensitive than LVEF in identifying IHD patients with normal LVEF at rest.