Assessment of left ventricular mechanical dyssynchrony by phase analysis of ECG-gated SPECT myocardial perfusion imaging |
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Authors: | Ji Chen Maureen M. Henneman Mark A. Trimble Jeroen J. Bax Salvador Borges-Neto Ami E. Iskandrian Kenneth J. Nichols Ernest V. Garcia |
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Affiliation: | (1) Department of Radiology, Emory University School of Medicine, 1364 Clifton Rd, 30322 Atlanta, GA;(2) Department of Cardiology, Leiden University, Leiden, The Netherlands;(3) Division of Cardiovascular Disease, Duke University, Durham, NC;(4) Division of Cardiology, University of Alabama at Birmingham, Birmingham, Ala.;(5) Division of Nuclear Medicine and Molecular Imaging, North Shore Long Island Jewish Health System, New Hyde Park, NY |
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Abstract: | Cardiac resynchronization therapy (CRT) has shown benefits in patients with severe heart failure. However, at least 30% of patients selected for CRT by use of traditional criteria (New York Heart Association class III or IV, depressed left ventricular [LV] ejection fraction, and prolonged QRS duration) do not respond to CRT. Recent studies with tissue Doppler imaging have shown that the presence of LV dyssynchrony is an important predictor of response to CRT. Phase analysis has been developed to allow assessment of LV dyssynchrony by gated single photon emission computed tomography myocardial perfusion imaging. This technique uses Fourier harmonic functions to approximate regional wall thickness changes over the cardiac cycle and to calculate the regional onset-of-mechanical contraction phase. Once the onset-of-mechanical contraction phases are obtained 3-dimensionally over the left ventricle, a phase distribution map is formed that represents the degree of LV dyssynchrony. This technique has been compared with other methods of measuring LV dyssynchrony and shown promising results in clinical evaluations. In this review the phase analysis methodology is described, and its up-to-date validations are summarized. |
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Keywords: | Heart failure cardiac resynchronization therapy left ventricular dyssynchrony electrocardiography-gated single photon emission computed tomography myocardial perfusion imaging |
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