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Long-term prognostic value of left ventricular dyssynchrony assessment by phase analysis from myocardial perfusion imaging
  1. Aju P Pazhenkottil1,
  2. Ronny R Buechel1,
  3. Lars Husmann1,
  4. René N Nkoulou1,
  5. Mathias Wolfrum1,
  6. Jelena-Rima Ghadri1,
  7. Janine Kummer1,
  8. Bernhard A Herzog1,
  9. Philipp A Kaufmann1,2
  1. 1Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
  2. 2Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Switzerland
  1. Correspondence to Philipp A Kaufmann, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, CH-8091 Zurich, Switzerland; pak{at}


Objective To assess the value of left ventricular (LV) dyssynchrony, using phase analysis of nuclear single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) as independent predictor of cardiac events.

Methods Phase analysis using Emory Cardiac Toolbox was applied on gated rest MPI scans to assess LV dyssynchrony in a total of 202 patients. Follow-up was obtained in 197 patients (97.5%). Major adverse cardiac events (MACE) (cardiac death and hospitalisation for any cardiac reasons, including worsening of heart failure, non-fatal myocardial infarction, unstable angina and coronary revascularisation) were determined using the Kaplan–Meier method. Cox proportional hazard regression was used to identify independent predictors of cardiac events.

Results At a median follow-up of 3.2±1.2 years, 41 patients had at least one event, including 5 cardiac deaths. LV dyssynchrony (n=35) was associated with a significantly higher incidence of MACE (p<0.001) and proved to be an independent predictor of cardiac events.

Conclusion LV dyssynchrony assessed by phase analysis of gated SPECT-MPI is a strong predictor of MACE independent of other known predictors such as perfusion defects or decreased LV ejection fraction.

  • Left ventricular dyssynchrony
  • phase analysis
  • myocardial perfusion imaging (MPI)
  • independent outcome predictor
  • cardiac events
  • nuclear cardiology
  • radionuclide imaging
  • myocardial perfusion

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  • See Editorial, p 4

  • Funding The study was supported by a grant from the Swiss National Science Foundation.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the local ethics committee of the University Hospital Zurich.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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