Repeatability and Reproducibility of Phase Analysis of Gated Single-photon Emission Computed Tomography Myocardial Perfusion Imaging Used to Quantify Cardiac Dyssynchrony

Overview

Journal Nucl Med Commun

Specialty Nuclear Medicine

Date 2008 Mar 5

PMID 18317303

Citations 69

Authors

Mark A Trimble

Eric J Velazquez

George L Adams

Emily F Honeycutt

Robert A Pagnanelli

Huiman X Barnhart

Ji Chen

Ami E Iskandrian

Ernest V Garcia

Salvador Borges-Neto

Affiliations

Soon will be listed here.

Abstract

Background: A novel method to quantify dyssynchrony has been developed using phase analysis of gated single-photon emission computed tomography perfusion imaging. We report on the effect of variability in image reconstruction on the phase analysis results (repeatability) and on the interobserver and intraobserver reproducibility of the technique.

Methods: Phase standard deviation (SD) and bandwidth are phase indices that quantify dyssynchrony. To evaluate repeatability, raw data sets were processed twice in 50 patients with left ventricular dysfunction and 50 normal controls. To determine the optimal processing method, two replicated phase analysis results were obtained using automated and manual base parameter placement. Reproducibility of the phase analysis was determined using the data from 20 patients.

Results: In normal controls, manual base parameter placement improves repeatability of the phase analysis as measured by the mean absolute difference between two reads for phase SD (12.0 degrees vs. 1.2 degrees , P<0.0001) and bandwidth (33.7 degrees vs. 3.6 degrees , P<0.0001). Repeatability is better for normal controls than for patients with left ventricular dysfunction for phase SD (1.2 degrees vs. 6.0 degrees , P<0.0001) and bandwidth (3.6 degrees vs. 26.5 degrees , P<0.0001). Reproducibility of the phase analysis is high as measured by the intraclass correlation coefficients for phase SD and bandwidth of 0.99 and 0.99 for the interobserver comparisons and 1.00 and 1.00 for the intraobserver comparisons.

Conclusion: A novel method to quantify dyssynchrony has been developed using gated single-photon emission computed tomography perfusion imaging. Manual base parameter placement reduces the effect that variability in image reconstruction has on phase analysis. A high degree of reproducibility of phase analysis is observed.

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References

Popovic Z, Grimm R, Perlic G, Chinchoy E, Geraci M, Sun J . Noninvasive assessment of cardiac resynchronization therapy for congestive heart failure using myocardial strain and left ventricular peak power as parameters of myocardial synchrony and function. J Cardiovasc Electrophysiol. 2003; 13(12):1203-8. DOI: 10.1046/j.1540-8167.2002.01203.x. View

Sogaard P, Egeblad H, Pedersen A, Kim W, Kristensen B, Hansen P . Sequential versus simultaneous biventricular resynchronization for severe heart failure: evaluation by tissue Doppler imaging. Circulation. 2002; 106(16):2078-84. DOI: 10.1161/01.cir.0000034512.90874.8e. View

Henneman M, Chen J, Dibbets-Schneider P, Stokkel M, Bleeker G, Ypenburg C . Can LV dyssynchrony as assessed with phase analysis on gated myocardial perfusion SPECT predict response to CRT?. J Nucl Med. 2007; 48(7):1104-11. DOI: 10.2967/jnumed.107.039925. View

Bax J, Bleeker G, Marwick T, Molhoek S, Boersma E, Steendijk P . Left ventricular dyssynchrony predicts response and prognosis after cardiac resynchronization therapy. J Am Coll Cardiol. 2004; 44(9):1834-40. DOI: 10.1016/j.jacc.2004.08.016. View

Yu C, Zhang Q, Fung J, Chan H, Chan Y, Yip G . A novel tool to assess systolic asynchrony and identify responders of cardiac resynchronization therapy by tissue synchronization imaging. J Am Coll Cardiol. 2005; 45(5):677-84. DOI: 10.1016/j.jacc.2004.12.003. View

Trimble M, Borges-Neto S, Smallheiser S, Chen J, Honeycutt E, Shaw L . Evaluation of left ventricular mechanical dyssynchrony as determined by phase analysis of ECG-gated SPECT myocardial perfusion imaging in patients with left ventricular dysfunction and conduction disturbances. J Nucl Cardiol. 2007; 14(3):298-307. DOI: 10.1016/j.nuclcard.2007.01.041. View

Gorcsan 3rd J, Kanzaki H, Bazaz R, Dohi K, Schwartzman D . Usefulness of echocardiographic tissue synchronization imaging to predict acute response to cardiac resynchronization therapy. Am J Cardiol. 2004; 93(9):1178-81. DOI: 10.1016/j.amjcard.2004.01.054. View

Breithardt O, Stellbrink C, Herbots L, Claus P, Sinha A, Bijnens B . Cardiac resynchronization therapy can reverse abnormal myocardial strain distribution in patients with heart failure and left bundle branch block. J Am Coll Cardiol. 2003; 42(3):486-94. DOI: 10.1016/s0735-1097(03)00709-5. View

Ypenburg C, Schalij M, Bleeker G, Steendijk P, Boersma E, Dibbets-Schneider P . Extent of viability to predict response to cardiac resynchronization therapy in ischemic heart failure patients. J Nucl Med. 2006; 47(10):1565-70. View

10.

Sun J, Chinchoy E, Donal E, Popovic Z, Perlic G, Asher C . Evaluation of ventricular synchrony using novel Doppler echocardiographic indices in patients with heart failure receiving cardiac resynchronization therapy. J Am Soc Echocardiogr. 2004; 17(8):845-50. DOI: 10.1016/j.echo.2004.04.012. View

11.

Leclercq C, Faris O, Tunin R, Johnson J, Kato R, Evans F . Systolic improvement and mechanical resynchronization does not require electrical synchrony in the dilated failing heart with left bundle-branch block. Circulation. 2002; 106(14):1760-3. DOI: 10.1161/01.cir.0000035037.11968.5c. View

12.

Chen J, Garcia E, Folks R, Cooke C, Faber T, Tauxe E . Onset of left ventricular mechanical contraction as determined by phase analysis of ECG-gated myocardial perfusion SPECT imaging: development of a diagnostic tool for assessment of cardiac mechanical dyssynchrony. J Nucl Cardiol. 2005; 12(6):687-95. DOI: 10.1016/j.nuclcard.2005.06.088. View

13.

Yu C, Fung W, Lin H, Zhang Q, Sanderson J, Lau C . Predictors of left ventricular reverse remodeling after cardiac resynchronization therapy for heart failure secondary to idiopathic dilated or ischemic cardiomyopathy. Am J Cardiol. 2003; 91(6):684-8. DOI: 10.1016/s0002-9149(02)03404-5. View

14.

Penicka M, Bartunek J, De Bruyne B, Vanderheyden M, Goethals M, DE Zutter M . Improvement of left ventricular function after cardiac resynchronization therapy is predicted by tissue Doppler imaging echocardiography. Circulation. 2004; 109(8):978-83. DOI: 10.1161/01.CIR.0000116765.43251.D7. View

15.

Bax J, Marwick T, Molhoek S, Bleeker G, van Erven L, Boersma E . Left ventricular dyssynchrony predicts benefit of cardiac resynchronization therapy in patients with end-stage heart failure before pacemaker implantation. Am J Cardiol. 2003; 92(10):1238-40. DOI: 10.1016/j.amjcard.2003.06.016. View

16.

Bax J, Abraham T, Barold S, Breithardt O, Fung J, Garrigue S . Cardiac resynchronization therapy: Part 1--issues before device implantation. J Am Coll Cardiol. 2005; 46(12):2153-67. DOI: 10.1016/j.jacc.2005.09.019. View

17.

Brecker S, Xiao H, Sparrow J, Gibson D . Effects of dual-chamber pacing with short atrioventricular delay in dilated cardiomyopathy. Lancet. 1992; 340(8831):1308-12. DOI: 10.1016/0140-6736(92)92492-x. View

18.

Henneman M, Chen J, Ypenburg C, Dibbets P, Bleeker G, Boersma E . Phase analysis of gated myocardial perfusion single-photon emission computed tomography compared with tissue Doppler imaging for the assessment of left ventricular dyssynchrony. J Am Coll Cardiol. 2007; 49(16):1708-14. DOI: 10.1016/j.jacc.2007.01.063. View

19.

Sogaard P, Egeblad H, Kim W, Jensen H, Pedersen A, Kristensen B . Tissue Doppler imaging predicts improved systolic performance and reversed left ventricular remodeling during long-term cardiac resynchronization therapy. J Am Coll Cardiol. 2002; 40(4):723-30. DOI: 10.1016/s0735-1097(02)02010-7. View

20.

Young J, Abraham W, Smith A, Leon A, Lieberman R, Wilkoff B . Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: the MIRACLE ICD Trial. JAMA. 2003; 289(20):2685-94. DOI: 10.1001/jama.289.20.2685. View