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Cardiac remodelling in association with left ventricular dyssynchrony and systolic dysfunction in patients with

Hanna Hämäläinen1,2, Tiina M Laitinen1, Marja Hedman2,3

  • 1Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.

Clinical Physiology and Functional Imaging
|July 18, 2022
PubMed

Insights

Left ventricular remodelling (LVR) is common in coronary artery disease (CAD) and linked to dysfunction. Myocardial perfusion imaging (MPI) effectively assesses LVR, identifying changes before heart failure symptoms appear.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Coronary artery disease (CAD) can lead to ischaemic cardiomyopathy, characterized by cardiac remodelling and left ventricular (LV) dysfunction.
  • Myocardial perfusion imaging (MPI) is a valuable tool for quantifying LV size, shape, mechanical dyssynchrony (LVMD), ejection fraction (EF), and myocardial ischaemia/injury.
  • Understanding the prevalence of LV remodelling (LVR) and its relationship with LVMD and EF in CAD patients is crucial.

Purpose of the Study:

  • To investigate the prevalence of LV remodelling (LVR) in patients with coronary artery disease (CAD).
  • To examine the relationship between LVR, LV mechanical dyssynchrony (LVMD), and ejection fraction (EF) in CAD patients.
  • To assess the utility of MPI in characterizing LVR and its association with systolic dysfunction.

Main Methods:

  • Evaluated 326 patients with CAD using MPI.
  • Measured EF and end-diastolic volume (EDV) via MPI.
  • Assessed LVMD using phase analysis and LVR by LV dilatation or shape indices (SIES, SIED).

Main Results:

  • LVR was observed in 41% of CAD patients.
  • Patients with LVMD or low EF exhibited larger EDV, SIES, and SIED.
  • Phase histogram bandwidth correlated with EDV and SIES; EF correlated with EDV, SIES, and SIED after adjustments.

Conclusions:

  • LV remodelling is frequent in CAD and can precede symptomatic heart failure.
  • Increased LV volume and spherical shape are associated with LVMD and reduced EF.
  • MPI effectively assesses LVR, providing insights into LV size and shape changes indicative of ischaemic cardiomyopathy.
Abstract

Keywords:
coronary artery diseaseejection fractionheart failureleft ventricular mechanical dyssynchronyphase analysisremodellingshape indexsingle-photon emission computed tomography

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