TY - JOUR
T1 - Assessment of diastolic function using 16-frame99mTc-sestamibi gated myocardial perfusion SPECT
T2 - Normal values
AU - Akincioglu, Cigdem
AU - Berman, Daniel S.
AU - Nishina, Hidetaka
AU - Kavanagh, Paul B.
AU - Slomka, Piotr J.
AU - Abidov, Aiden
AU - Hayes, Sean
AU - Friedman, John D.
AU - Germano, Guido
PY - 2005
Y1 - 2005
N2 - The purposes of this study were (a) to assess the feasibility of diastolic function (DFx)evaluation using standard 16-frame post-exercise gated 99mTc-sestamibi myocardial perfusion SPECT (MPS), (b) to determine the relationship of the 2 common DFx parameters, peak filling rate (PFR) and time to peak filling (TTPF), to clinical and systolic function (SFx) variables in patients with normal myocardial perfusion and SFx, and (c) to derive and validate normal limits. Methods: Ninety patients (71 men; age, 30-79 y) with normal exercise gated MPS were studied. None had hypertension, diabetes, rest electrocardiogram abnormality, or known cardiac disease. All patients reached ≥85% of maximum predicted heart rate (HR). The population was randomized into derivation (n = 50) and validation (n = 40) groups. Univariable and multivariable approaches were deployed to assess the influence of clinical and functional variables on DFx parameters. Results: PFR and TTPF were assessed in all patients. Mean values of PFR and TTPF in the whole study population were 2.62 ± 0.46 end-diastolic volumes per second (EDV/s) and 164.6 ± 21.7 ms, respectively. By applying a 2-SD cutoff to the mean values in the derivation group, the threshold for abnormal PFR and the threshold for abnormal TTPF were <1.71 EDV/s and >216.7 ms, respectively. The normalcy rates in the validation group for PFR and TTPF were both 100%. The PFR showed weak but significant correlations with age, EDV, end-systolic volume, left ventricular election fraction (LVEF), and poststress HR. However, TTPF did not correlate with these parameters. Final normal thresholds determined from the combined populations were PFR = 1.70 EDV/s and TTPF = 208 ms. Multivariable analysis showed that age, sex, LVEF, and HR are strong predictors for PFR, whereas TTPF was not influenced by any clinical or SFx variable. Conclusion: With a new algorithm in QGS, assessment of LV DFx is feasible using 16-frame gated MPS even without bad-beat rejection, resulting in normal limits similar to those reported with gated blood-pool studies. However, due to the dependency of PFR on SFx parameters, sex, HR, and age, TTPF appears to be a stable and more useful parameter with this approach. The clinical usefulness of these findings requires further study.
AB - The purposes of this study were (a) to assess the feasibility of diastolic function (DFx)evaluation using standard 16-frame post-exercise gated 99mTc-sestamibi myocardial perfusion SPECT (MPS), (b) to determine the relationship of the 2 common DFx parameters, peak filling rate (PFR) and time to peak filling (TTPF), to clinical and systolic function (SFx) variables in patients with normal myocardial perfusion and SFx, and (c) to derive and validate normal limits. Methods: Ninety patients (71 men; age, 30-79 y) with normal exercise gated MPS were studied. None had hypertension, diabetes, rest electrocardiogram abnormality, or known cardiac disease. All patients reached ≥85% of maximum predicted heart rate (HR). The population was randomized into derivation (n = 50) and validation (n = 40) groups. Univariable and multivariable approaches were deployed to assess the influence of clinical and functional variables on DFx parameters. Results: PFR and TTPF were assessed in all patients. Mean values of PFR and TTPF in the whole study population were 2.62 ± 0.46 end-diastolic volumes per second (EDV/s) and 164.6 ± 21.7 ms, respectively. By applying a 2-SD cutoff to the mean values in the derivation group, the threshold for abnormal PFR and the threshold for abnormal TTPF were <1.71 EDV/s and >216.7 ms, respectively. The normalcy rates in the validation group for PFR and TTPF were both 100%. The PFR showed weak but significant correlations with age, EDV, end-systolic volume, left ventricular election fraction (LVEF), and poststress HR. However, TTPF did not correlate with these parameters. Final normal thresholds determined from the combined populations were PFR = 1.70 EDV/s and TTPF = 208 ms. Multivariable analysis showed that age, sex, LVEF, and HR are strong predictors for PFR, whereas TTPF was not influenced by any clinical or SFx variable. Conclusion: With a new algorithm in QGS, assessment of LV DFx is feasible using 16-frame gated MPS even without bad-beat rejection, resulting in normal limits similar to those reported with gated blood-pool studies. However, due to the dependency of PFR on SFx parameters, sex, HR, and age, TTPF appears to be a stable and more useful parameter with this approach. The clinical usefulness of these findings requires further study.
KW - Cardiac function quantification
KW - Diastolic function
KW - Gated myocardial perfusion SPECT
KW - Normal limits
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M3 - Article
C2 - 16000278
AN - SCOPUS:23844508214
SN - 0161-5505
VL - 46
SP - 1102
EP - 1108
JO - Journal of Nuclear Medicine
JF - Journal of Nuclear Medicine
IS - 7
ER -