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Comparison of the dyssynchrony parameters recorded with gated SPECT in ischemic cardiomyopathy according to their repeatability at rest and to their ability to detect a synchrony reserve under dobutamine infusion

  • Damien Legallois
  • Pierre-Yves Marie
  • Philippe R. Franken
  • Wassila Djaballah
  • Denis Agostini
  • Alain Manrique
Original Article

Abstract

Background

This study aimed to determine whether the repeatability of dyssynchrony assessment using gated myocardial perfusion SPECT (GSPECT) allows the detection of synchrony reserve during low-dose dobutamine infusion.

Methods and Results

Sixty-one patients with ischemic cardiomyopathy and LV ejection fraction < 50% were prospectively included in 10 centers. Each patient underwent two consecutive rest GSPECT with 99mTc-labeled tracer (either tetrofosmin or sestamibi) to assess the repeatability of LV function and dyssynchrony parameters, followed by a GSECT acquisition during low-dose dobutamine infusion. LV dyssynchrony was assessed using QGS software through histogram bandwidth (BW), standard deviation of the phase (SD), and entropy. Repeatability was assessed with Lin’s concordance correlation coefficient (CCC). Entropy showed a higher CCC (0.80) compared to BW (0.68) and SD (0.75). On average, dobutamine infusion yielded to improve both BW (P = .049) and entropy (P = .04) although significant improvements, setting outside the 95% confidence interval of the repeatability analysis, were documented in only 6 and 4 patients for BW and entropy, respectively.

Conclusions

A synchrony reserve may be documented in patients with ischemic cardiomyopathy through the recording of BW and entropy with low-dose dobutamine GSPECT, with the additional advantage of a higher repeatability for entropy.

Keywords

Gated single-photon emission computed tomography heart failure ischemic cardiomyopathy left ventricular dyssynchrony dobutamine infusion 

Abbreviations

BW

Bandwidth of the phase

CCC

Concordance correlation coefficient

DS-GSPECT

Low-dose dobutamine stress gated single-photon emission computed tomography

GSPECT

Gated myocardial perfusion single-photon emission computed tomography

LV

Left ventricular

LVEF

Left ventricular ejection fraction

SD

Standard deviation of the phase

SPECT

Single-photon emission computed tomography

SRS:

Summed rest score

WTS

Wall thickening score

Notes

Acknowledgements

Sabrina PROD’HOMME is acknowledged for her technical assistance. MJ Alibelli (Centre Hospitalier Universitaire Rangueil, Toulouse, France), H Benhabib (Centre Hospitalier de Corbeil, Corbeil, France), A Devillers (CRLCC Eugène Marquis, Rennes, France), V Eder (Centre Hospitalier Universitaire Trousseau, Tours, France), P Guillo (Centre Hospitalier Universitaire de la Cavale Blanche, Brest, France), JF Toussaint (Hôpital Européen George Pompidou, Paris, France), and P Weinmann (Hôpital Avicenne, Bobigny, France) are acknowledged for their participation in this study.

Disclosure

The authors have indicated that they have no financial conflict of interest.

Supplementary material

12350_2018_1546_MOESM1_ESM.doc (73 kb)
Supplementary material 1 (DOC 73 kb)
12350_2018_1546_MOESM2_ESM.pptx (1.1 mb)
Supplementary material 2 (PPTX 1097 kb)

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Copyright information

© American Society of Nuclear Cardiology 2018

Authors and Affiliations

  • Damien Legallois
    • 1
    • 2
  • Pierre-Yves Marie
    • 3
  • Philippe R. Franken
    • 4
  • Wassila Djaballah
    • 3
  • Denis Agostini
    • 1
    • 5
  • Alain Manrique
    • 1
    • 5
    • 6
  1. 1.Normandie Université, UNICAEN, Signalisation, électrophysiologie et imagerie des lésions d’ischémie-reperfusion myocardiqueFHU REMOD-VHFCaenFrance
  2. 2.Department of CardiologyCHU de CaenCaenFrance
  3. 3.Department of Nuclear MedicineCHU de NancyNancyFrance
  4. 4.AZ-VUB Nuclear Medicine JetteBrusselsBelgium
  5. 5.Department of Nuclear MedicineCHU de CaenCaenFrance
  6. 6.Investigations chez l’HommeGIP Cyceron PET CenterCaenFrance

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