Original articleOnset of left ventricular mechanical contraction as determined by phase analysis of ECG-gated myocardial perfusion SPECT imaging: Development of a diagnostic tool for assessment of cardiac mechanical dyssynchrony
Section snippets
OMC Normal Databases
Forty-five men and forty-five women with a less than 5% likelihood of coronary artery disease were enrolled, retrospectively, for the development of the OMC normal databases. Each subject underwent a standard Tl-201/Tc-99m sestamibi dual-isotope rest/exercise stress protocol. The exercise stress imaging was done with ECG-gated SPECT by use of 8 frames per cardiac cycle. The stress short-axis data sets were generated by Butterworth filtering, followed by filtered backprojection reconstruction
Results
The male and female mean normal phase polar maps and histograms are shown in Figure 2. The mean normal phase polar maps showed that the OMC wave starts in the mid anterior and anteroseptal region and propagates quickly to the apex and base. The SD of the phase at the base of the left ventricle was remarkably high because of the error introduced by the automatic determination of the basal slice limit in some studies. The mean normal histograms showed that the OMC phases of a normal poststressed
Discussion
The diagnostic tool described herein includes OMC normal databases and dynamic OMC displays. OMC is an important parameter of cardiac function, in addition to SWT, obtained from ECG-gated SPECT MPI by count-based methods. Count-based methods have been validated by several investigators. Cooke et al,12 from our group, used simulation studies based on a single normal canine study to evaluate the errors associated with the count-based method used in the developed tool. It has been demonstrated
Acknowledgment
Some of the authors (Ernest V. Garcia, Russell D. Folks, C. David Cooke, and Tracy L. Faber) receive royalties for the sale of the Emory Cardiac Toolbox. The other authors have indicated they have no financial conflicts of interest.
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