Phase analysis for ventricular arrhythmia prediction: A retrospective monocentric cohort study

Area of Science:

• Cardiology
• Nuclear Medicine
• Medical Imaging

Background:

• Ventricular arrhythmias (VA) prediction often relies on left ventricular ejection fraction (LVEF), which has limited performance.
• Echocardiographic mechanical dispersion is a promising parameter but can be limited by acoustic windows.
• Nuclear imaging offers a potential alternative for assessing mechanical dispersion.

Purpose of the Study:

• To evaluate the ability of mechanical dispersion, measured by phase standard deviation (PSD) using radionuclide angiocardiography (RNA), to predict VA.
• To compare the predictive value of RNA-derived mechanical dispersion against traditional parameters like LVEF and global longitudinal strain (GLS).

Main Methods:

• Retrospective observational study of 937 patients undergoing tomographic RNA from 2015-2019.
• Phase analysis of RNA data was used to calculate PSD.
• Patient follow-up data were analyzed for VA, heart transplantation, and mortality events.

Main Results:

• A total of 86 (9%) patients experienced VA. Increased PSD was strongly associated with VA occurrence (HR 1.12 per 10 ms increase).
• PSD also showed significant associations with heart transplantation and death.
• The predictive value of PSD for VA remained significant after adjusting for LVEF, GLS, and other clinical factors.

Conclusions:

• Mechanical dispersion assessed by PSD on RNA is a valuable predictor of VA.
• RNA-derived mechanical dispersion offers an alternative when echocardiography is limited, providing independent prognostic information beyond LVEF and GLS.