篇名 | Left Ventricular Dyssynchrony Occurs Frequently in Patients with Coronary Artery Disease |
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卷期 | 26:4 |
作者 | Chang, Yen-Hsiang 、 Hsu, Chien-Chin 、 Wang, Pei-Wen 、 Huang, Yung-Cheng |
頁次 | 140-148 |
關鍵字 | Coronary artery disease 、 Gated SPECT myocardial perfusion 、 imaging 、 Left ventricular dyssynchrony 、 Thallium-201 |
出刊日期 | 201312 |
DOI | 10.3966/222696812013122604004 |
Background:Left ventricular (L V) dyssynchrony is an independent predictor of cardiac events or death in patients with coronary artery disease (CAD). Assessment of LV dyssynchrony has been approached with phase analysis of ECG-gated SPECT myocardial perfusion imaging (MPI). The aims of this study are to evaluate the prevalence of LV dyssynchrony in patients with CAD and to determine factors associated with LV dyssynchrony. Methods:Seventy consecutive patients with CAD underwent Tl-201 gated SPECT MPI were enrolled in this retrospective study. Seventy patients with low likelihood of CAD and normal gated SPECT MPI were enrolled as normal group. LY perfusion, function, and mechanical synchrony parameters were calculated using QPS® and QGS® software package. The upper limit of LY mechanical synchrony parameters phase histogram bandwidth (PHB) and phase standard deviation (PSD) values were defined as the mean plus 2 standard deviations of the normal group. Results:The upper limit of PHB and PSD were 49.4° and 12.5°, respectively. The prevalence of LV dyssynchrony in CAD patients was 31 % (22/70). The CAD patients with LV dyssynchrony had higher percentage of prior myocardial infarction and fixed defect, higher rest heart rate, larger LV volume indices, and lower LV ejection fraction (LVEF) than those without LV dyssynchrony. There was a significant negative correlation between LVEF and LV mechanical synchrony parameters. A multivariate analysis revealed that rest heart rate, total perfusion defect of stress images, and LV volume were independent factors associated with LY dyssynchrony in patients with CAD. Conclusion:LV dyssynchrony occurred frequently in patients with CAD. LY dyssynchrony was significantly associated with functional and morphological deterioration. Increased rest heart rate, larger total perfusion defects, and dilated LV chamber cavity were independent factors ofLV dyssynchrony in patients with CAD.