Assessment of ventricular systolic synchrony and ventricular function with gated myocardial perfusion imaging in patients with chronic heart failure

Abstract

Objective To retrospectively analyze the cardiac systolic synchrony and cardiac function in patients with chronic heart failure (CHF) by gated SPECT myocardial perfusion imaging (GSMPI). Methods (1) From January 2010 to February 2015, 123 cases including 82 CHF patients (57 males, 25 females, age (59.5±11.0) years) and 41 healthy people (control group; 27 males, 14 females, age (33.8±5.2) years) were enrolled in this retrospective study. According to the New York Heart Association (NYHA) classification, the CHF patients were classified into grade Ⅰ-Ⅳ groups. The systolic synchrony and cardiac functional parameters including PHB, PSD, LVEF, EDV, summed rest scores (SRS) were acquired by Emory Cardiac Toolbox software. Differences of PHB, PSD and LVEF were compared between the CHF group and the control group using two-sample t test. The difference among the four CHF groups was compared by one-way analysis of variance. The difference of some clinical factors was compared between the two groups with and without damage of systolic synchrony. The relationship between the cardiac synchrony and myocardial perfusion was analyzed by Pearson correlation analysis. Results There was no obvious difference of PHB and PSD between the grade Ⅰ CHF patients and the control group (t=-1.502 and -0.448, both P>0.05), while LVEF was significant different (t=10.419, P<0.05). Significant difference of PHB, PSD and LVEF existed between the grade Ⅱ-Ⅳ CHF patients and the control group (t values: from -27.250 to 32.723, all P<0.05). There were significant differences of PHB, PSD and LVEF among the 4 CHF groups (F=118.05, 4.13 and 154.37; all P<0.05). The differences of LVEF, EDV and SRS were significant between the patients with and without damage of systolic synchrony (t=9.57, 10.85, 18.87, all P<0.05). The ratios of damage in systolic synchrony in grade Ⅰ-Ⅳ CHF patients were 8.7% (2/23), 60.0%(12/20), 15/18 and 100% (21/21), respectively. PHB and PSD were both positively correlated with SRS (r=0.808 and 0.773, both P<0.05). Conclusions The damage of systolic synchrony are getting severer from patients with NYHA grade Ⅱ to patients with NYHA grade Ⅳ. The damage could be accompanied by the heart failure progression. Diabetes mellitus, LVEF, EDV, ESV, and SRS are related to the damage. The myocardial perfusion damage is positively correlated with the damage of cardiac systolic synchrony. GSMPI is useful to early diagnosis and treatment of heart failure. Key words: Heart failure; Myocardial contraction; Ventricular function; Myocardial perfusion imaging; Tomography, single-photon, emission-computed; Technetium Tc 99m sestamibi