Prognostic Role of Diastolic Left Ventricular Mechanical Dyssynchrony by Gated Single Photon Emission Computed Tomography Myocardial Perfusion Imaging in Post-Myocardial Infarction
Le Ngoc Ha1, Nguyen Thi Thanh Trung2, Mai Hong Son1
1Department of Nuclear Medicine, Hospital 108, Hanoi, Vietnam.
Insights
Diastolic mechanical dyssynchrony (LVMD) measured by gated-SPECT myocardial perfusion imaging predicts major adverse cardiac events in post-myocardial infarction patients. These findings highlight LVMD parameters as crucial prognostic indicators.
Area of Science:
- Cardiology
- Nuclear Medicine
- Medical Imaging
Background:
- Myocardial infarction (MI) survivors face risks of major adverse cardiac events (MACE).
- Assessing prognosis in post-MI patients is crucial for guiding treatment strategies.
- Left ventricular mechanical dyssynchrony (LVMD) may impact cardiac function and outcomes.
Purpose of the Study:
- To evaluate the prognostic value of diastolic LVMD using gated-single photon emission computed tomography (GSPECT) myocardial perfusion imaging (MPI).
- To determine if LVMD parameters can predict MACE in patients after MI.
Main Methods:
- 106 post-MI patients were analyzed using GSPECT MPI.
- Diastolic LVMD indices, including phase standard deviation (PSD) and histogram bandwidth (HBW), were measured.
- Patients were followed for MACE, with prognostic value assessed via ROC and survival analyses.
Main Results:
- Specific cut-off values for PSD (55.5°) and HBW (174.5°) showed significant sensitivity and specificity in predicting MACE.
- Significant differences in time to MACE were observed between patient groups based on PSD levels.
- PSD, HBW, and left ventricle ejection fraction (LVEF) from GSPECT were significant predictors of MACE.
Conclusions:
- Diastolic LVMD parameters (PSD and HBW) derived from GSPECT MPI are significant prognostic factors.
- These parameters aid in predicting MACE in patients post-MI.
- GSPECT MPI offers valuable insights into diastolic dyssynchrony for risk stratification.
Abstract:
Objective This study is aimed to assess the prognostic value of diastolic left ventricular mechanical dyssynchrony (LVMD) measured by gated-single photon emission computed tomography (GSPECT) myocardial perfusion imaging (MPI) in post-myocardial infarction (MI). Subjects and Methods The study was conducted on 106 post-MI from January 2015 to January 2019. First, the indices of diastolic LVMD phase standard deviation (PSD) and histogram bandwidth (HBW) of post-MI were measured using the Cardiac Emory Toolbox. Subsequently, the post-MI patients were followed up, and the primary endpoint was major adverse cardiac events (MACEs). Finally, the prognostic value of dyssynchrony parameters for MACE was analyzed by the receiver-operating characteristics curve and survival analyses. Results With the cut-off values of 55.5 degrees of PSD, the sensitivity and specificity in prediction of MACE were 75% and 80.8%, with the cut-off values of 174.5 degrees of HBW, the sensitivity and specificity were 75% and 83.3% respectively. There was a significant difference of time to MACE between groups of PSD less than 55.5 degrees and more than 55.5 degrees. PSD, HBW, and left ventricle ejection fraction (LVEF) assessed on GSPECT were significant factors in the prediction of MACE. Conclusion Diastolic LVMD parameters of PSD and HBW derived from GSPECT are significant prognostic factors in predicting MACE in post-MI patients.
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