Incremental value of myocardial wall motion and thickening to perfusion alone by gated SPECT myocardial perfusion imaging for viability assessment in patients with ischemic heart failure
The objective of this study was to assess the incremental value of myocardial wall motion and thickening compared with perfusion alone obtained from gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in diagnosing myocardial viability in patients with ischemi...
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| Veröffentlicht in: | Journal of nuclear cardiology 2021-12, Vol.28 (6), p.2545-2556 |
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| creator | Zhang, Feifei Wang, Jianfeng Shao, Xiaoliang Yang, Minfu Qian, Yongxiang Yang, Xiaoyu Wu, Zhifang Li, Sijin Xin, Wenchong Shi, Yunmei Liu, Bao Yu, Wenji He, Zhuo Zhou, Weihua Wang, Yuetao |
| description | The objective of this study was to assess the incremental value of myocardial wall motion and thickening compared with perfusion alone obtained from gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in diagnosing myocardial viability in patients with ischemic heart failure.
Eighty-three consecutive patients with ischemic heart failure who underwent both 99mTc-MIBI gated SPECT MPI and 18F-FDG positron emission tomography (PET) myocardial metabolic imaging were retrospectively enrolled. SPECT/PET myocardial viability was defined as the reference standard. Segmental myocardial perfusion, wall motion, and thickening were measured by an automated algorithm from gated SPECT MPI. Univariate and stepwise multivariate analysis were conducted to establish an optimal multivariate model for predicting hibernating myocardium and scar.
Among the 1411 segments evaluated, 774 segments had normal perfusion and 637 segments had decreased perfusion. The latter were classified by 18F-FDG PET into 338 hibernating segments and 299 scarred segments. The multivariate regression analysis showed that the model that combined myocardial perfusion uptake with wall motion and thickening scores had the optimal predictive efficiency to distinguish hibernating myocardium from scar in the segments with decreased perfusion. The model had the largest C-statistic (0.753 vs 0.666, P < 0.0001), and the global chi-square was increased from 53.281 to 111.234 when compared with perfusion alone (P < 0.001).
Assessment of myocardial wall motion and thickening in addition to conventional perfusion uptake in the segments with decreased perfusion enables better differentiation of hibernating myocardium from scar in patients with ischemic heart failure. Considering wide availability and high cost-effectiveness, regional myocardial function integrated with perfusion on gated SPECT MPI has great promise to become a clinical tool in the assessment of myocardial viability. |
| doi_str_mv | 10.1007/s12350-020-02040-4 |
| format | Article |
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Eighty-three consecutive patients with ischemic heart failure who underwent both 99mTc-MIBI gated SPECT MPI and 18F-FDG positron emission tomography (PET) myocardial metabolic imaging were retrospectively enrolled. SPECT/PET myocardial viability was defined as the reference standard. Segmental myocardial perfusion, wall motion, and thickening were measured by an automated algorithm from gated SPECT MPI. Univariate and stepwise multivariate analysis were conducted to establish an optimal multivariate model for predicting hibernating myocardium and scar.
Among the 1411 segments evaluated, 774 segments had normal perfusion and 637 segments had decreased perfusion. The latter were classified by 18F-FDG PET into 338 hibernating segments and 299 scarred segments. The multivariate regression analysis showed that the model that combined myocardial perfusion uptake with wall motion and thickening scores had the optimal predictive efficiency to distinguish hibernating myocardium from scar in the segments with decreased perfusion. The model had the largest C-statistic (0.753 vs 0.666, P < 0.0001), and the global chi-square was increased from 53.281 to 111.234 when compared with perfusion alone (P < 0.001).
Assessment of myocardial wall motion and thickening in addition to conventional perfusion uptake in the segments with decreased perfusion enables better differentiation of hibernating myocardium from scar in patients with ischemic heart failure. Considering wide availability and high cost-effectiveness, regional myocardial function integrated with perfusion on gated SPECT MPI has great promise to become a clinical tool in the assessment of myocardial viability.</description><identifier>ISSN: 1071-3581</identifier><identifier>ISSN: 1532-6551</identifier><identifier>EISSN: 1532-6551</identifier><identifier>DOI: 10.1007/s12350-020-02040-4</identifier><identifier>PMID: 32060856</identifier><language>eng</language><publisher>Cham: Elsevier Inc</publisher><subject>Aged ; Cardiac-Gated Imaging Techniques ; Cardiology ; Female ; gated ; Heart - physiopathology ; Heart failure ; Heart Failure - complications ; Heart Failure - diagnostic imaging ; Heart Failure - physiopathology ; hibernating myocardium ; Hibernation ; Humans ; Imaging ; ischemic heart failure ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Myocardial Ischemia - complications ; Myocardial Ischemia - diagnostic imaging ; Myocardial Ischemia - physiopathology ; Myocardial perfusion imaging ; Myocardial Perfusion Imaging - methods ; Myocardium - pathology ; Nuclear Medicine ; Original Article ; Radiology ; Retrospective Studies ; Tomography ; Tomography, Emission-Computed, Single-Photon ; wall motion ; wall thickening</subject><ispartof>Journal of nuclear cardiology, 2021-12, Vol.28 (6), p.2545-2556</ispartof><rights>2021 American Society of Nuclear Cardiology. Published by ELSEVIER INC. All rights reserved.</rights><rights>American Society of Nuclear Cardiology 2020</rights><rights>2020. American Society of Nuclear Cardiology.</rights><rights>American Society of Nuclear Cardiology 2020.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c528t-3319594454f39b1fa3ef53cdeb60f6cf6a2a61e565c69f61e3b43761cfda457e3</citedby><cites>FETCH-LOGICAL-c528t-3319594454f39b1fa3ef53cdeb60f6cf6a2a61e565c69f61e3b43761cfda457e3</cites><orcidid>0000-0003-2859-8625</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12350-020-02040-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12350-020-02040-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32060856$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhang, Feifei</creatorcontrib><creatorcontrib>Wang, Jianfeng</creatorcontrib><creatorcontrib>Shao, Xiaoliang</creatorcontrib><creatorcontrib>Yang, Minfu</creatorcontrib><creatorcontrib>Qian, Yongxiang</creatorcontrib><creatorcontrib>Yang, Xiaoyu</creatorcontrib><creatorcontrib>Wu, Zhifang</creatorcontrib><creatorcontrib>Li, Sijin</creatorcontrib><creatorcontrib>Xin, Wenchong</creatorcontrib><creatorcontrib>Shi, Yunmei</creatorcontrib><creatorcontrib>Liu, Bao</creatorcontrib><creatorcontrib>Yu, Wenji</creatorcontrib><creatorcontrib>He, Zhuo</creatorcontrib><creatorcontrib>Zhou, Weihua</creatorcontrib><creatorcontrib>Wang, Yuetao</creatorcontrib><title>Incremental value of myocardial wall motion and thickening to perfusion alone by gated SPECT myocardial perfusion imaging for viability assessment in patients with ischemic heart failure</title><title>Journal of nuclear cardiology</title><addtitle>J. Nucl. Cardiol</addtitle><addtitle>J Nucl Cardiol</addtitle><description>The objective of this study was to assess the incremental value of myocardial wall motion and thickening compared with perfusion alone obtained from gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in diagnosing myocardial viability in patients with ischemic heart failure.
Eighty-three consecutive patients with ischemic heart failure who underwent both 99mTc-MIBI gated SPECT MPI and 18F-FDG positron emission tomography (PET) myocardial metabolic imaging were retrospectively enrolled. SPECT/PET myocardial viability was defined as the reference standard. Segmental myocardial perfusion, wall motion, and thickening were measured by an automated algorithm from gated SPECT MPI. Univariate and stepwise multivariate analysis were conducted to establish an optimal multivariate model for predicting hibernating myocardium and scar.
Among the 1411 segments evaluated, 774 segments had normal perfusion and 637 segments had decreased perfusion. The latter were classified by 18F-FDG PET into 338 hibernating segments and 299 scarred segments. The multivariate regression analysis showed that the model that combined myocardial perfusion uptake with wall motion and thickening scores had the optimal predictive efficiency to distinguish hibernating myocardium from scar in the segments with decreased perfusion. The model had the largest C-statistic (0.753 vs 0.666, P < 0.0001), and the global chi-square was increased from 53.281 to 111.234 when compared with perfusion alone (P < 0.001).
Assessment of myocardial wall motion and thickening in addition to conventional perfusion uptake in the segments with decreased perfusion enables better differentiation of hibernating myocardium from scar in patients with ischemic heart failure. Considering wide availability and high cost-effectiveness, regional myocardial function integrated with perfusion on gated SPECT MPI has great promise to become a clinical tool in the assessment of myocardial viability.</description><subject>Aged</subject><subject>Cardiac-Gated Imaging Techniques</subject><subject>Cardiology</subject><subject>Female</subject><subject>gated</subject><subject>Heart - physiopathology</subject><subject>Heart failure</subject><subject>Heart Failure - complications</subject><subject>Heart Failure - diagnostic imaging</subject><subject>Heart Failure - physiopathology</subject><subject>hibernating myocardium</subject><subject>Hibernation</subject><subject>Humans</subject><subject>Imaging</subject><subject>ischemic heart failure</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Myocardial Ischemia - complications</subject><subject>Myocardial Ischemia - diagnostic imaging</subject><subject>Myocardial Ischemia - physiopathology</subject><subject>Myocardial perfusion imaging</subject><subject>Myocardial Perfusion Imaging - methods</subject><subject>Myocardium - pathology</subject><subject>Nuclear Medicine</subject><subject>Original Article</subject><subject>Radiology</subject><subject>Retrospective Studies</subject><subject>Tomography</subject><subject>Tomography, Emission-Computed, Single-Photon</subject><subject>wall motion</subject><subject>wall thickening</subject><issn>1071-3581</issn><issn>1532-6551</issn><issn>1532-6551</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9Uk1v1DAUjBCIfsAf4IAsceESsOPYu5GQEFq1UKkSSJSz5TjPiYtjL7az1f41fh3OprSFQw-Wn_xmxm_0piheEfyOYLx6H0lFGS5xdTg1LusnxTFhtCo5Y-RprvGKlJStyVFxEuM1xrihTfO8OKIV5njN-HHx-8KpACO4JC3aSTsB8hqNe69k6Ex-u5HWotEn4x2SrkNpMOonOON6lDzaQtBTPPSsd4DaPeplgg59_3a2uXqoc480o-xnuvYB7YxsjTVpj2SMEOM8CDIObWUyuYzoxqQBmagGGI1CA8iQkJbGTgFeFM-0tBFe3t6nxY_zs6vNl_Ly6-eLzafLUrFqnUpKScOauma1pk1LtKSgGVUdtBxrrjSXleQEGGeKNzpXtK3pihOlO1mzFdDT4uOiu53aETqV5wrSim3IRsJeeGnEvx1nBtH7nSC44WSF66zw9lYh-F8TxCTGbAmslQ78FEVeI2soZ3SdoW_-g177KbjsT1SczLus1ySjqgWlgo8xgL6bhmAxZ0Ms2RA5F-KQDTFP8fqhjzvK3zBkAF0AMbdcD-H-70dlPywsyDvYmcyKKu9OQWcCqCQ6bx6j_wF0k91C</recordid><startdate>20211201</startdate><enddate>20211201</enddate><creator>Zhang, Feifei</creator><creator>Wang, Jianfeng</creator><creator>Shao, Xiaoliang</creator><creator>Yang, Minfu</creator><creator>Qian, Yongxiang</creator><creator>Yang, Xiaoyu</creator><creator>Wu, Zhifang</creator><creator>Li, Sijin</creator><creator>Xin, Wenchong</creator><creator>Shi, Yunmei</creator><creator>Liu, Bao</creator><creator>Yu, Wenji</creator><creator>He, Zhuo</creator><creator>Zhou, Weihua</creator><creator>Wang, Yuetao</creator><general>Elsevier Inc</general><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2859-8625</orcidid></search><sort><creationdate>20211201</creationdate><title>Incremental value of myocardial wall motion and thickening to perfusion alone by gated SPECT myocardial perfusion imaging for viability assessment in patients with ischemic heart failure</title><author>Zhang, Feifei ; Wang, Jianfeng ; Shao, Xiaoliang ; Yang, Minfu ; Qian, Yongxiang ; Yang, Xiaoyu ; Wu, Zhifang ; Li, Sijin ; Xin, Wenchong ; Shi, Yunmei ; Liu, Bao ; Yu, Wenji ; He, Zhuo ; Zhou, Weihua ; Wang, Yuetao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c528t-3319594454f39b1fa3ef53cdeb60f6cf6a2a61e565c69f61e3b43761cfda457e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Cardiac-Gated Imaging Techniques</topic><topic>Cardiology</topic><topic>Female</topic><topic>gated</topic><topic>Heart - physiopathology</topic><topic>Heart failure</topic><topic>Heart Failure - complications</topic><topic>Heart Failure - diagnostic imaging</topic><topic>Heart Failure - physiopathology</topic><topic>hibernating myocardium</topic><topic>Hibernation</topic><topic>Humans</topic><topic>Imaging</topic><topic>ischemic heart failure</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Myocardial Ischemia - complications</topic><topic>Myocardial Ischemia - diagnostic imaging</topic><topic>Myocardial Ischemia - physiopathology</topic><topic>Myocardial perfusion imaging</topic><topic>Myocardial Perfusion Imaging - methods</topic><topic>Myocardium - pathology</topic><topic>Nuclear Medicine</topic><topic>Original Article</topic><topic>Radiology</topic><topic>Retrospective Studies</topic><topic>Tomography</topic><topic>Tomography, Emission-Computed, Single-Photon</topic><topic>wall motion</topic><topic>wall thickening</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, Feifei</creatorcontrib><creatorcontrib>Wang, Jianfeng</creatorcontrib><creatorcontrib>Shao, Xiaoliang</creatorcontrib><creatorcontrib>Yang, Minfu</creatorcontrib><creatorcontrib>Qian, Yongxiang</creatorcontrib><creatorcontrib>Yang, Xiaoyu</creatorcontrib><creatorcontrib>Wu, Zhifang</creatorcontrib><creatorcontrib>Li, Sijin</creatorcontrib><creatorcontrib>Xin, Wenchong</creatorcontrib><creatorcontrib>Shi, Yunmei</creatorcontrib><creatorcontrib>Liu, Bao</creatorcontrib><creatorcontrib>Yu, Wenji</creatorcontrib><creatorcontrib>He, Zhuo</creatorcontrib><creatorcontrib>Zhou, Weihua</creatorcontrib><creatorcontrib>Wang, Yuetao</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of nuclear cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, Feifei</au><au>Wang, Jianfeng</au><au>Shao, Xiaoliang</au><au>Yang, Minfu</au><au>Qian, Yongxiang</au><au>Yang, Xiaoyu</au><au>Wu, Zhifang</au><au>Li, Sijin</au><au>Xin, Wenchong</au><au>Shi, Yunmei</au><au>Liu, Bao</au><au>Yu, Wenji</au><au>He, Zhuo</au><au>Zhou, Weihua</au><au>Wang, Yuetao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incremental value of myocardial wall motion and thickening to perfusion alone by gated SPECT myocardial perfusion imaging for viability assessment in patients with ischemic heart failure</atitle><jtitle>Journal of nuclear cardiology</jtitle><stitle>J. Nucl. Cardiol</stitle><addtitle>J Nucl Cardiol</addtitle><date>2021-12-01</date><risdate>2021</risdate><volume>28</volume><issue>6</issue><spage>2545</spage><epage>2556</epage><pages>2545-2556</pages><issn>1071-3581</issn><issn>1532-6551</issn><eissn>1532-6551</eissn><abstract>The objective of this study was to assess the incremental value of myocardial wall motion and thickening compared with perfusion alone obtained from gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in diagnosing myocardial viability in patients with ischemic heart failure.
Eighty-three consecutive patients with ischemic heart failure who underwent both 99mTc-MIBI gated SPECT MPI and 18F-FDG positron emission tomography (PET) myocardial metabolic imaging were retrospectively enrolled. SPECT/PET myocardial viability was defined as the reference standard. Segmental myocardial perfusion, wall motion, and thickening were measured by an automated algorithm from gated SPECT MPI. Univariate and stepwise multivariate analysis were conducted to establish an optimal multivariate model for predicting hibernating myocardium and scar.
Among the 1411 segments evaluated, 774 segments had normal perfusion and 637 segments had decreased perfusion. The latter were classified by 18F-FDG PET into 338 hibernating segments and 299 scarred segments. The multivariate regression analysis showed that the model that combined myocardial perfusion uptake with wall motion and thickening scores had the optimal predictive efficiency to distinguish hibernating myocardium from scar in the segments with decreased perfusion. The model had the largest C-statistic (0.753 vs 0.666, P < 0.0001), and the global chi-square was increased from 53.281 to 111.234 when compared with perfusion alone (P < 0.001).
Assessment of myocardial wall motion and thickening in addition to conventional perfusion uptake in the segments with decreased perfusion enables better differentiation of hibernating myocardium from scar in patients with ischemic heart failure. Considering wide availability and high cost-effectiveness, regional myocardial function integrated with perfusion on gated SPECT MPI has great promise to become a clinical tool in the assessment of myocardial viability.</abstract><cop>Cham</cop><pub>Elsevier Inc</pub><pmid>32060856</pmid><doi>10.1007/s12350-020-02040-4</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-2859-8625</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Cardiac-Gated Imaging Techniques Cardiology Female gated Heart - physiopathology Heart failure Heart Failure - complications Heart Failure - diagnostic imaging Heart Failure - physiopathology hibernating myocardium Hibernation Humans Imaging ischemic heart failure Male Medicine Medicine & Public Health Middle Aged Myocardial Ischemia - complications Myocardial Ischemia - diagnostic imaging Myocardial Ischemia - physiopathology Myocardial perfusion imaging Myocardial Perfusion Imaging - methods Myocardium - pathology Nuclear Medicine Original Article Radiology Retrospective Studies Tomography Tomography, Emission-Computed, Single-Photon wall motion wall thickening |
| title | Incremental value of myocardial wall motion and thickening to perfusion alone by gated SPECT myocardial perfusion imaging for viability assessment in patients with ischemic heart failure |
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