Interactions between myocardial sympathetic denervation and left ventricular mechanical dyssynchrony: A CZT analysis

Journal Article · Mon Apr 15 04:00:00 EDT 2019 · Journal of Nuclear Cardiology (Online)

DOI:https://doi.org/10.1007/S12350-017-1036-3· OSTI ID:22962135

Gimelli, Alessia ^[1]; Liga, Riccardo ^[2]; Menichetti, Francesca; Soldati, Ezio; Bongiorni, Maria Grazia ^[3]; Marzullo, Paolo ^[1]

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1. Fondazione Toscana Gabriele Monasterio (Italy)
2. University of Pisa (Italy)
3. University Hospital of Pisa, Cardio-Thoracic and Vascular department (Italy)

Background: A correlation between left ventricular (LV) dyssynchrony (LVD) and impaired myocardial sympathetic tone has been hypothesized. We sought to assess the interactions between regional LV sympathetic innervation, perfusion, and mechanical dyssynchrony. Methods: Eighty-three patients underwent evaluation of LV perfusion and sympathetic innervation on {sup 99m}Tc-tetrofosmin/{sup 123}I-metaiodobenzylguanidine ({sup 123}I-MIBG) imaging. The summed rest score and summed {sup 123}I-MIBG score (SS-MIBG) were computed. The extent of “innervation/perfusion” mismatch was defined as the number of denervated LV segments with relatively preserved perfusion. LVD was evaluated on phase analysis and the wall with latest mechanical activation identified. Results: LVD was revealed in 36 (43%) patients. Patients with LVD had more abnormal values of SRS (21 ± 9 vs 10 ± 8, P < 0.001) and SS-MIBG (29 ± 9 vs 17 ± 11, P < 0.001) than those without LVD. The presence of LVD also clustered with a higher burden of “innervation/perfusion” mismatch (P = 0.019). On per-wall analysis, LV walls with delayed mechanical activation showed a higher burden of “innervation/perfusion” mismatch (2.3 ± 1.4 segments) than normally contracting walls (1.3 ± 1.2 segments; P < 0.001). On multivariate analysis, the extent of “innervation/perfusion” mismatch was the only predictor of delayed mechanical activation (P = 0.029). Conclusions: Patients with LVD show an elevated burden of “innervation/perfusion” mismatch that is concentrated at the level of the most dyssynchronous walls.

• OSTI ID: 22962135
• Journal Information: Journal of Nuclear Cardiology (Online), Journal Name: Journal of Nuclear Cardiology (Online) Journal Issue: 2 Vol. 26; ISSN 1532-6551
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CDZNTE SEMICONDUCTOR DETECTORS
IODINE 123
MIBG
PATIENTS
PHASE STUDIES
TECHNETIUM 99