Diagnostic Value of Vasodilator-Induced Left Ventricular Dyssynchrony as Assessed by Phase Analysis to Detect Multivessel Coronary Artery Disease
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- Tanaka Hirokazu
- Department of Cardiology, Tokyo Medical University Ibaraki Medical Center
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- Chikamori Taishiro
- Department of Cardiology, Tokyo Medical University
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- Hida Satoshi
- Department of Cardiology, Tokyo Medical University
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- Igarashi Yuko
- Department of Cardiology, Tokyo Medical University
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- Shiba Chie
- Department of Cardiology, Tokyo Medical University
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- Usui Yasuhiro
- Department of Cardiology, Tokyo Medical University
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- Hatano Tsuguhisa
- Department of Cardiology, Tokyo Medical University
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- Yamashina Akira
- Department of Cardiology, Tokyo Medical University
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説明
Purpose: Phase analysis was recently developed to allow left ventricular (LV) mechanical dyssynchrony to be assessed by gated single-photon emission computed tomography (SPECT). However, few studies have analyzed LV dyssynchrony during pharmacological stress and at rest by applying phase analysis to detect multivessel coronary artery disease (CAD) using the SyncToolTM.<Br>Methods: Adenosine triphosphate (ATP) loading electrocardiogram-gated 99mTc-sestamibi SPECT was performed on 180 patients with suspected or known CAD. LV dyssynchrony was evaluated using the SyncToolTM; the phase standard deviation (SD) and histogram bandwidth were derived.<Br>Results: The summed stress score (SSS), summed difference score (SDS), post-stress increase in phase SD, and histogram bandwidth were greater in 78 patients with multivessel CAD than in 102 patients with insignificant or single-vessel CAD. In the detection of multivessel CAD, SSS of >9 and SDS of >5 showed sensitivities of 74% and 74%,and specificities of 71% and 78% respectively, whereas an increase in phase SD >8.3° and in histogram bandwidth >16° after ATP loading had sensitivities of 62% and 74% and specificities of 77% and 68%, respectively. A multivariate logistic analysis revealed that the identification of multivessel CAD was superior with the combination of a post-ATP increase in phase SD, increase in histogram bandwidth, and SDS (sensitivity 82%, specificity 76%, chi-square＝80.0) than with SDS alone (sensitivity 74%, specificity 78%, chi-square＝58.9).<Br>Conclusion: The addition of ATP-induced LV dyssynchrony parameters to conventional perfusion analysis enabled the superior identification of patients with multivessel CAD.
収録刊行物
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- Annals of Nuclear Cardiology
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Annals of Nuclear Cardiology 1 (1), 6-17, 2015
日本心臓核医学会
