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Prognostic value of left ventricular mechanical dyssynchrony induced by exercise stress in patients with normal myocardial perfusion single-photon emission computed tomography
- Source :
- Journal of Nuclear Cardiology. 29:1-10
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- Left ventricular mechanical dyssynchrony (LVMD) induced by exercise stress was reported to be clinically useful in detecting multivessel coronary artery diseases. The aim of this study was to compare the prognostic value of LVMD induced by pharmacological stress with that induced by exercise stress. We retrospectively examined 918 consecutive patients who underwent exercise (N = 310) or pharmacological stress (N = 608) 99mTc-tetrofosmin single-photon emission computed tomography (SPECT) with normal myocardial perfusion. LVMD was evaluated by phase analysis as the indices of phase bandwidth and phase standard deviation (PSD). During the follow-up period (2.2 ± 1.9 years), 74 major cardiac events (MCEs) occurred (7 cases of cardiac death, 17 cases of heart failure, and 50 cases of coronary intervention). In global patients, the indices of LVMD on rest images were significantly greater in patients with MCEs (bandwidth (°): 51 ± 31 vs 37 ± 21, P = .001, PSD: 14 ± 9 vs 10 ± 6, P = .001). The exercise stress bandwidth was significantly higher in patients with MCEs (62 ± 37° vs 42 ± 21°, P = .026), as was the pharmacological stress bandwidth (57 ± 35° vs 43 ± 24°, P = .006). Multivariate analysis demonstrated the exercise stress bandwidth to be an independent predictor of MCEs (HR 1.017, CI 1.003 to 1.032, P = .019), but the pharmacological stress bandwidth had no influence on MCEs. LVMD induced by exercise stress was an independent predictor of MCEs in patients with normal perfusion SPECT, whereas that induced by pharmacological stress had no association with further events.
- Subjects :
- medicine.medical_specialty
030204 cardiovascular system & hematology
Single-photon emission computed tomography
Pharmacological stress
030218 nuclear medicine & medical imaging
Ventricular Dysfunction, Left
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Radiology, Nuclear Medicine and imaging
In patient
Retrospective Studies
Tomography, Emission-Computed, Single-Photon
medicine.diagnostic_test
business.industry
Myocardial Perfusion Imaging
Exercise stress
Prognosis
medicine.disease
Perfusion
Heart failure
Cardiology
Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography
Cardiology and Cardiovascular Medicine
Phase analysis
business
Emission computed tomography
Subjects
Details
- ISSN :
- 15326551 and 10713581
- Volume :
- 29
- Database :
- OpenAIRE
- Journal :
- Journal of Nuclear Cardiology
- Accession number :
- edsair.doi.dedup.....064be5337b1a9d776d8548d6a51f1bdc