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Clinical values of left ventricular mechanical dyssynchrony assessment by gated myocardial perfusion SPECT in patients with acute myocardial infarction and multivessel disease

  • Sang-Geon Cho
  • Zeenat Jabin
  • Ki Seong Park
  • Jahae Kim
  • Sae-Ryung Kang
  • Seong Young Kwon
  • Geum-Cheol Jeong
  • Minchul Song
  • Jong Sang Kim
  • Jae Yeong Cho
  • Hyun Kuk Kim
  • Ho-Chun Song
  • Jung-Joon Min
  • Hee-Seung BomEmail author
Original Article

Abstract

Purpose

The aim of this study was to evaluate the prognostic value of additional evaluation of left ventricular mechanical dyssynchrony (LVMD) by gated myocardial perfusion single-photon emission computed tomography (GMPS) in patients with acute myocardial infarction (MI) and multivessel disease.

Methods

One hundred and nine acute MI patients with >50 % stenosis in at least one non-culprit artery who underwent GMPS within 2 weeks were enrolled. All patients underwent successful revascularization of the culprit arteries. Those with previous MI, atrial fibrillation, or frequent ventricular premature complexes, cardiac devices, significant patient motion, or procedure-related events were excluded. Phase standard deviation (PSD) and phase histogram bandwidth (PBW) were measured for assessment of LVMD. Patients were followed up for a median of 26 months after index MI, for composite major adverse cardiac events (MACE), which consisted with all-cause death, unplanned hospitalization due to heart failure and severe ventricular arrhythmias (sustained ventricular tachycardia or ventricular fibrillation). Independent predictors of MACE were evaluated.

Results

MACE occurred in 22 patients (20 %). Stress PSD (53.3 ± 17.3° vs. 35.3 ± 18.9°; p <0.001), stress PBW (147.6 ± 54.6° vs. 96.8 ± 59.2°; p = 0.001) and resting PBW (126.8 ± 37.5° vs. 96.6 ± 48.9°; p = 0.001) were significantly higher in patients with MACE compared to those without. Multivariate analysis revealed that stress PSD ≥45.5° and stress PBW ≥126.0° were predictive of MACE, as well as suboptimal non-culprit artery revascularization (SNR) and renin-angiotensin system (RAS) blockade medication. Higher stress PSD and stress PBW were associated with poorer prognosis both in patients with and without SNR, and those with RAS blockade medication, but not in those without RAS blockade medication.

Conclusions

LVMD measured by GMPS showed added prognostic value in acute MI with multivessel disease. GMPS could serve as a comprehensive evaluation imaging tool in patients with acute MI and multivessel disease.

Keywords

Left ventricular mechanical dyssynchrony Gated myocardial perfusion single photon emission computed tomography Acute myocardial infarction Multivessel disease 

Notes

Compliance with ethical standards

Conflict of interest

Sang-Geon Cho, Zeenat Jabin, Ki Seong Park, Jahae Kim, Sae-Ryung Kang, Seong Young Kwon, Geum-Cheol Jeong, Minchul Song, Jong Sang Kim, Jae Yeong Cho, Hyun Kuk Kim, Ho-Chun Song, Jung-Joon Min, and Hee-Seung Bom declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The requirement to obtain was waived in this retrospective study.

Supplementary material

259_2016_3542_MOESM1_ESM.docx (1.4 mb)
ESM 1 (DOCX 1396 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Sang-Geon Cho
    • 1
  • Zeenat Jabin
    • 2
  • Ki Seong Park
    • 1
  • Jahae Kim
    • 1
  • Sae-Ryung Kang
    • 2
  • Seong Young Kwon
    • 2
  • Geum-Cheol Jeong
    • 2
  • Minchul Song
    • 2
  • Jong Sang Kim
    • 1
  • Jae Yeong Cho
    • 3
  • Hyun Kuk Kim
    • 3
  • Ho-Chun Song
    • 1
  • Jung-Joon Min
    • 2
  • Hee-Seung Bom
    • 2
    Email author
  1. 1.Department of Nuclear MedicineChonnam National University HospitalGwang-juRepublic of Korea
  2. 2.Department of Nuclear MedicineChonnam National University Hwasun HospitalHwasun-gunSouth Korea
  3. 3.Department of CardiologyChonnam National University HospitalGwang-juRepublic of Korea

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