Background: To detect ischemia in patients with angina and normal coronaries frequently represents a complex diagnosis.
Methods: To investigate whether left ventricular mechanical dyssynchrony by phase analysis contributes in the evaluation of patients with chest pain and normal coronaries, gated-SPECT myocardial perfusion imaging (MPI) at rest and 30 minutes post-stress was performed in 218 patients with normal epicardial coronaries, who were divided into two groups: those with summed difference score (SDS) ≥ 4 (54 patients, Group 1), and those with SDS < 4 (164 patients, Group 2). Intraventricular synchronism-phase standard deviation (PSD) and histogram bandwidth (HBW)-was evaluated by phase analysis.
Results: Women were significantly more frequent in Group 2 (those without ischemia in SPECT MPI): 113 (69%) vs 25 (46%), P = .00001. In males, left ventricular ejection fraction (LVEF) and ventricular volumes were not significantly different between patients with or without ischemia. However, ischemic females showed significantly higher ventricular volumes, minor post-stress LVEF and more negative delta LVEF (- 3.9 vs 0.34, P = .0008) than the non-ischemic ones. There was a significant post-stress increase of PSD and HBW among males, although not among females. According to SSS (≥ 4, with ischemia/necrosis; < 4, without ischemia/necrosis), post-stress PSD and HBW significantly increase both in male and female, and PSD and HBW were significantly higher in females with SSS ≥ 4 compared to those with SSS < 4 (PSD rest: 19.04° vs 11.72°, P < .0001; HBW rest: 58.85° vs 38.21°, P < .0001). PSD and HBW were also higher among males with SSS ≥ 4 compared to those with SSS < 4, although not significantly.
Conclusion: Higher ventricular volumes in females and dyssynchrony are associated with inducible ischemia in MPI in patients with chest pain and normal coronaries. Stress-induced ischemia increases degree of dyssynchrony.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s12350-019-01804-x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Anthracycline-induced cardiomyopathy: risk prediction, prevention and treatment.
Nat Rev Cardiol
January 2025
Cardioncology Unit, Cardioncology and Second Opinion Division, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy.
Anthracyclines are the cornerstone of treatment for many malignancies. However, anthracycline cardiotoxicity is a considerable concern given that it can compromise the clinical effectiveness of the treatment and patient survival despite early discontinuation of therapy or dose reduction. Patients with cancer receiving anthracycline treatment can have a reduction in their quality of life and likelihood of survival due to cardiotoxicity, irrespective of their oncological prognosis.
View Article and Find Full Text PDFNon-bacterial thrombotic endocarditis in a patient with high-grade serous ovarian carcinoma: diagnostic challenges and management insights.
BMJ Case Rep
January 2025
Cardiology, East Cheshire NHS Trust, Macclesfield, UK.
Non-bacterial thrombotic endocarditis (NBTE) is characterised by sterile vegetations on heart valves and often emerges in hypercoagulable states like malignancy. It is frequently underdiagnosed and only comes to light during postmortem examination. Early diagnosis and treatment with anticoagulation can help lower mortality.
View Article and Find Full Text PDFHemodynamic analysis of left ventricular unloading with Impella versus IABP during VA-ECMO.
Acta Bioeng Biomech
June 2024
1Department of Biomedical Engineering, Hefei University of Technology, Hefei, People's Republic of China.
: The utilization of intra-aortic balloon pump (IABP) and Impella has been suggested as means of left ventricular unloading in veno-arterial extracorporeal membrane oxygenation (VA-ECMO) patients. This study aimed to assess the local hemodynamic alterations in VA-ECMO patients through simulation analyses. : In this study, a 0D-3D multiscale model was developed, wherein resistance conditions were employed to define the flow-pressure relationship.
View Article and Find Full Text PDFThe European Registry for Patients with Mechanical Circulatory Support (EUROMACS) of the European Association for Cardio-Thoracic Surgery Fourth report: Focus on standardized outcome ratios.
Eur J Cardiothorac Surg
January 2025
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany. DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.
Objectives: This fourth report aimed to provide insights into patient characteristics, outcomes, and standardized outcome ratios of patients implanted with durable Mechanical Circulatory Support across participating centers in the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) registry.
Methods: All registered patients receiving durable mechanical circulatory support up to August 2024 were included. Expected number of events were predicted using penalized logistic regression.
Left Atrial Remodeling and Function in Various Left Ventricular Hypertrophic Phenotypes.
Eur Heart J Cardiovasc Imaging
January 2025
Heart Institute. Department of Cardiology. Cardiovascular Imaging Unit. Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
Aims: How the underlying etiology and pathophysiology of left ventricular (LV) hypertrophy affects LA remodeling and function remains unexplored. The present study aims to investigate the influence of various hypertrophic phenotypes on LA remodeling and function.
Methods And Results: Patients with LV hypertrophy who underwent cardiac magnetic resonance (CMR) were compared to a control group.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!