Regional left-ventricular diastolic wall motion assessed by a new program for ECG-gated myocardial perfusion SPECT in early-stage heart failure.

摘要

BACKGROUND: We developed a new program for gated single-photon emission computed tomography to estimate regional left-ventricular (LV) wall motion. We classified and graded diastolic wall motion, and compared its grading with global LV functions. METHODS AND RESULTS: Forty New York Heart Association functional class I (NYHA class I) patients and 15 control subjects were examined. The global time to peak filling and the regional diastolic wall motion synchrony, as estimated by the time lag between the earliest and latest regional peak filling, were evaluated. Using the control group's mean + 2 SD, diastolic wall motions were classified into four subsets: globally normal and regionally synchronous, globally normal but regionally dyssynchronous, globally prolonged and regionally dyssynchronous, and globally prolonged but regionally synchronous. These subsets were graded 0 to 3, respectively. Grade 0 was defined as normal. Grading was compared with global LV functions. Although 67.5% of patients demonstrated abnormal motion, the global diastolic parameter less frequently detected an abnormality (22.5% to 32.5%). Grading correlated with the first-third filling fraction (Spearman's rank correlation coefficient [rs] = -0.74, P = 3.8 x 10(-6)) and the first-third filling rate (rs = -0.49, P .005). CONCLUSIONS: Regional diastolic wall motion abnormality was frequently detected even in early-stage heart failure. Grading reflected early diastolic dysfunction.