Nuclear Medicine Department, Hospital Universitario Antonio Pedro-EBSERH-UFF, 303 Marquês de Parana street, Niterói, Rio de Janeiro, 24033-900, Brazil.
Nuclear Medicine Department, Institute of Cardiology, La Habana, Cuba.
J Nucl Cardiol. 2022 Jun;29(3):952-961. doi: 10.1007/s12350-020-02397-6. Epub 2020 Oct 20.
Gated myocardial perfusion scintigraphy (GMPS) phase analysis is an important tool to investigate the physiology of left ventricular (LV) dyssynchrony. We aimed to test the performance of GMPS LV function and phase analysis in different clinical settings and on a diverse population.
This is a post hoc analysis of a prospective, non-randomized, multinational, multicenter cohort study. Clinical evaluation and GMPS prior to cardiac resynchronization therapy (CRT)(baseline) and 6-month post CRT (follow-up) were done. LV end-systolic volume (LVESV), LV end-diastolic volume (LVEDV), LV ejection fraction (LVEF), LV phase standard deviation (LVPSD), and percentage of left ventricle non-viable (PLVNV) were obtained by 10 centers and compared to the core lab.
276 GMPS studies had all data available from individual sites and from core lab. There were no statistically significant differences between all variables except for LVPSD. When subjects with no mechanical dyssynchrony were excluded, LVPSD difference became non-significant. LVESV, LVEF, LVPSD and PLVNV had strong correlation in site against core lab comparison. Bland-Altman plots demonstrated good agreement.
The presented correlation and agreement of LV function and dyssynchrony analysis over different sites with a diverse sample corroborate the strength of GMPS in the management of heart failure in clinical practice.
门控心肌灌注闪烁显像(GMPS)相位分析是研究左心室(LV)不同步生理的重要工具。我们旨在测试 GMPS 在不同临床环境和不同人群中的 LV 功能和相位分析性能。
这是一项前瞻性、非随机、多国、多中心队列研究的事后分析。在心脏再同步治疗(CRT)之前(基线)和 CRT 后 6 个月(随访)进行临床评估和 GMPS。通过 10 个中心获得 LV 收缩末期容积(LVESV)、LV 舒张末期容积(LVEDV)、LV 射血分数(LVEF)、LV 相位标准差(LVPSD)和左心室无活力百分比(PLVNV),并与核心实验室进行比较。
276 项 GMPS 研究均获得了来自各中心和核心实验室的所有数据。除 LVPSD 外,所有变量之间均无统计学差异。当排除无机械不同步的患者时,LVPSD 的差异变得无统计学意义。LVESV、LVEF、LVPSD 和 PLVNV 在站点与核心实验室比较方面具有较强的相关性。Bland-Altman 图表明具有良好的一致性。
不同站点和不同样本的 LV 功能和不同步分析的相关性和一致性证实了 GMPS 在心力衰竭临床管理中的强大作用。