Abstract:
PURPOSE:Left ventricular (LV) mechanical dyssynchrony (LVMD) was assessed by gated single-photon emission CT myocardial perfusion imaging (MPI) as an independent predictor of death from any cause in patients with known coronary artery disease (CAD) and reduced LV function. METHODS:Between 2001 and 2010, 135 patients (64 ± 11 years of age, 84 % men) with known CAD, reduced LV ejection fraction (LVEF, 38 ± 15 %) and without an implanted cardiac resynchronization therapy device underwent gated MPI at rest. LV functional evaluation, which included phase analysis, was conducted to identify patients with LVMD. Kaplan-Meier survival curves were calculated for death of any cause during a mean follow-up of 2.0 ± 1.7 years. Uni- and multivariate Cox proportional hazards regression models were calculated to identify independent predictors of death from any cause. RESULTS:Of the 135 patients, 30 (22 %) died during follow-up (18 cardiac deaths and 12 deaths from other causes). Kaplan-Meier curves showed a significantly shorter survival time in the patients with severely reduced LVEF (<30 %, n = 45) or with LVMD (n = 81, log-rank test P <0.005). Cox models identified LVMD, LVEF < 30 % and a total perfusion deficit at rest of ≥ 20 % as independent predictors of death from any cause. While patients with LVEF <30 % in conjunction with LVMD had similar survival times irrespective of whether they had early revascularization or medical therapy, those patients with LVEF ≥ 30% and LVMD who underwent revascularization had significantly longer survival. CONCLUSION:In patients with known CAD and reduced LV function, dyssynchrony of the LV is an independent predictor of death from any cause.
journal_name
Eur J Nucl Med Mol Imagingauthors
Uebleis C,Hellweger S,Laubender RP,Becker A,Sohn HY,Lehner S,Haug A,Bartenstein P,Cumming P,Van Kriekinge SD,Slomka PJ,Hacker Mdoi
10.1007/s00259-012-2157-1subject
Has Abstractpub_date
2012-10-01 00:00:00pages
1561-9issue
10eissn
1619-7070issn
1619-7089journal_volume
39pub_type
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