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[Assessment of Left Ventricular Diastolic Function Using ECG-gated Myocardial Perfusion SPECT in Small Heart:

Taiki Chono1,2, Masahisa Onoguchi2, Akiyoshi Hashimoto3

  • 1Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital.

Nihon Hoshasen Gijutsu Gakkai Zasshi
|June 22, 2018
PubMed

Insights

Electrocardiogram (ECG)-gated SPECT shows potential for assessing left ventricular diastolic function in small hearts, unlike echocardiography. Heart Risk View-F software correlated better with early mitral annular velocity in small hearts, suggesting its utility for detecting myocardial ischemia.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Medical Imaging

Background:

  • Assessing left ventricular (LV) diastolic function is crucial for early detection of myocardial ischemia.
  • Small heart (SH) patients present unique challenges in diastolic function assessment.
  • Comparing electrocardiogram (ECG)-gated myocardial perfusion single photon emission computed tomography (G-SPECT) and echocardiography is vital for SH.

Purpose of the Study:

  • To compare the efficacy of G-SPECT and ultrasound echocardiography in evaluating LV diastolic function in small hearts.
  • To determine the reliability of different G-SPECT software (QGS and HRV-F) in assessing diastolic parameters in SH.

Main Methods:

  • 144 patients underwent both G-SPECT and echocardiography.
  • LV diastolic function parameters: Peak Filling Rate (PFR), one-third Mean Filling Rate (1/3 MFR), and Time to PFR/RR interval (TPFR/RR) were calculated using QGS and HRV-F.
  • Peak early mitral annular velocity (e') served as the reference standard.

Main Results:

  • In the smallest hearts (end-systolic volume ≤10 ml), PFR by QGS did not correlate with e', but PFR by HRV-F showed significant correlation (r=0.47, p=0.006).
  • 1/3 MFR and TPFR/RR, calculated by both QGS and HRV-F, did not correlate with e' in small hearts (SH10 and SH20).
  • All G-SPECT parameters (PFR, 1/3 MFR, TPFR/RR) correlated with e' in normal-sized hearts (NH).

Conclusions:

  • ECG-gated SPECT, particularly with HRV-F software, shows promise for assessing LV diastolic function in small hearts.
  • Standard echocardiography parameters may be less reliable in small hearts compared to G-SPECT.
  • Further research is warranted to validate G-SPECT's role in early myocardial ischemia detection in SH.
Abstract

Keywords:
echocardiographymyocardial perfusion SPECTsmall heart

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