Naoaki Kano1, Takahiro Okumura2, Satoshi Isobe1, Akinori Sawamura1, Naoki Watanabe1, Kenji Fukaya1, Hiroaki Mori1, Ryota Morimoto1,3, Katsuhiko Kato4, Yasuko K Bando1, Toyoaki Murohara1. 1. Department of Cardiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan. 2. Department of Cardiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan. takaoku@med.nagoya-u.ac.jp. 3. Department of CKD Initiatives Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan. 4. Department of Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Abstract
BACKGROUND: The prognostic impact and pathophysiology of global left ventricular mechanical dyssynchrony (LVMD), namely mechanical dyssynchrony of whole left ventricle, as assessed by phase analysis of electrocardiographically gated (ECG-gated) myocardial perfusion SPECT has not been clearly elucidated in patients with dilated cardiomyopathy (DCM) and narrow QRS complex (<120 ms). METHODS AND RESULTS: Forty-six patients with DCM underwent ECG-gated myocardial 99mTc-sestamibi perfusion SPECT and endomyocardial biopsy. LV phase entropy was automatically calculated using a phase analysis of ECG-gated myocardial perfusion SPECT. The patients were divided into two groups according to the median phase entropy value: low-phase entropy (<0.61) (N = 23: LE group) and high-phase entropy (≥0.61) (N = 23: HE group). In the Kaplan-Meier survival analysis, the event-free survival rate was significantly lower in the HE group (log-rank P = 0.015). Moreover, high-phase entropy was an independent predictor of adverse cardiac events (hazard ratio, 5.77%; 95% confidence interval, 1.02-108.32; P = 0.047). Interestingly, the mRNA expression levels of sarcoplasmic reticulum Ca2+-ATPase (SERCA2a) in endomyocardial biopsy specimens were significantly lower in the HE group (P = 0.015). CONCLUSION: LV phase entropy, which may reflect impairment of Ca2+ handling caused by decreased SERCA2a mRNA levels, is a novel prognostic predictor in patients with DCM and narrow QRS complex.
BACKGROUND: The prognostic impact and pathophysiology of global left ventricular mechanical dyssynchrony (LVMD), namely mechanical dyssynchrony of whole left ventricle, as assessed by phase analysis of electrocardiographically gated (ECG-gated) myocardial perfusion SPECT has not been clearly elucidated in patients with dilated cardiomyopathy (DCM) and narrow QRS complex (<120 ms). METHODS AND RESULTS: Forty-six patients with DCM underwent ECG-gated myocardial 99mTc-sestamibi perfusion SPECT and endomyocardial biopsy. LV phase entropy was automatically calculated using a phase analysis of ECG-gated myocardial perfusion SPECT. The patients were divided into two groups according to the median phase entropy value: low-phase entropy (<0.61) (N = 23: LE group) and high-phase entropy (≥0.61) (N = 23: HE group). In the Kaplan-Meier survival analysis, the event-free survival rate was significantly lower in the HE group (log-rank P = 0.015). Moreover, high-phase entropy was an independent predictor of adverse cardiac events (hazard ratio, 5.77%; 95% confidence interval, 1.02-108.32; P = 0.047). Interestingly, the mRNA expression levels of sarcoplasmic reticulum Ca2+-ATPase (SERCA2a) in endomyocardial biopsy specimens were significantly lower in the HE group (P = 0.015). CONCLUSION: LV phase entropy, which may reflect impairment of Ca2+ handling caused by decreased SERCA2a mRNA levels, is a novel prognostic predictor in patients with DCM and narrow QRS complex.
Entities:
Keywords:
SERCA2a; cardiomyopathy; dyssynchrony; gated SPECT; outcomes research
Authors: Serge D Van Kriekinge; Hidetaka Nishina; Muneo Ohba; Daniel S Berman; Guido Germano Journal: J Nucl Med Date: 2008-10-16 Impact factor: 10.057
Authors: Nathaniel M Hawkins; Mark C Petrie; Michael R MacDonald; Kerry J Hogg; John J V McMurray Journal: Eur Heart J Date: 2006-03-09 Impact factor: 29.983
Authors: Vladimir V Shipulin; Sergey L Andreev; Andrew S Pryakhin; Andrew V Mochula; Alina N Maltseva; Svetlana I Sazonova; Vladimir M Shipulin; Samia Massalha; Konstantin V Zavadovsky Journal: Eur J Nucl Med Mol Imaging Date: 2022-02-12 Impact factor: 10.057
Authors: Keiichiro Kuronuma; Robert J H Miller; Yuka Otaki; Serge D Van Kriekinge; Marcio A Diniz; Tali Sharir; Lien-Hsin Hu; Heidi Gransar; Joanna X Liang; Tejas Parekh; Paul B Kavanagh; Andrew J Einstein; Mathews B Fish; Terrence D Ruddy; Philipp A Kaufmann; Albert J Sinusas; Edward J Miller; Timothy M Bateman; Sharmila Dorbala; Marcelo Di Carli; Balaji K Tamarappoo; Damini Dey; Daniel S Berman; Piotr J Slomka Journal: Circ Cardiovasc Imaging Date: 2021-07-20 Impact factor: 7.792