新型半导体心脏专用SPECT相位分析技术评价左心室收缩同步性与收缩功能的相关性

Evaluation of correlation between left ventricular mechanical contraction synchrony and left ventricular systolic function using a novel Cadmium-Zinc-Telluride SPECT

目的应用新型半导体心脏专用碲锌镉(CZT)SPECT门控静息心肌灌注显像相位分析技术评价左室机械收缩同步性与收缩功能的相关性。方法回顾性收集2019年1月至8月于山西省心血管病医院行门控静息心肌灌注显像的患者343例[男232例,女111例,年龄(60.08±12.88)岁],所有患者行CZT SPECT门控静息心肌灌注显像。通过相位分析软件分获得左心室整体收缩功能参数[舒张末期容积(EDV)、收缩末期容积(ESV)、左心室射血分数(LVEF)]及左心室机械收缩同步性参数[相峰(PP)、相位标准差(PSD)、直方图带宽(PHB)、偏度(HS)、峰态(HK)]。将所有患者分为4组:心功能正常组(147例)、缺血性心肌病组(114例)、非缺血性心肌病无左束支阻滞组(50例)、非缺血性心肌病伴左束支阻滞组(32例)。采用Pearson相关分析收缩功能参数与同步性参数间的相关性。结果所有患者PP、PSD、PHB与LVEF均呈负相关(r值:-0.194、-0.790、-0.799,均P<0.01),其中PP与LVEF相关性不佳,HS、HK与LVEF呈正相关(r值:0.767、0.676,均P<0.01);PSD、PHB与ESV呈正相关(r值:0.778、0.795,均P<0.01),而PP与ESV相关性不佳(r=0.145,P<0.01);PSD、PHB与EDV呈正相关(r值:0.722、0.732,均P<0.01),而PP与EDV无相关性(r=0.095,P>0.01);HS、HK与EDV、ESV均呈负相关(r值:-0.700^-0.580,均P<0.01)。心功能正常组、缺血性心肌病组、非缺血性心肌病无左束支阻滞组和非缺血性心肌病左束支阻滞组PSD、PHB与LVEF均呈负相关(r值:-0.834^-0.492,均P<0.01),HS、HK与LVEF均呈正相关(r值:0.243~0.792,均P<0.01)。结论CZT SPECT相位分析技术所得左室机械收缩同步性定量参数与LVEF相关性较好,随着LVEF降低,左室机械收缩同步性变差。缺血性心肌病及非缺血性心肌病均能影响左室机械收缩同步性,从而影响左室收缩功能,并且非缺血性心肌病伴左束支阻滞患者左室机械收缩同步性受影响较大。

Objective To evaluate correlation between left ventricular mechanical contraction synchrony and left ventricular systolic function by gated myocardial perfusion imaging(GMPI)using Cadmium-Zine-Telluride(CZT)SPECT.Methods Three hundred and forty three consecutive patients(232 males,111 females,age(60.08±12.88)years)who underwent CZT SPECT GMPI in Shanxi Cardiovascular Hospital between January and August 2019 were retrospectively analyzed.The Emory cardiac toolbox was used to process the imaging data,and the left ventricular systolic synchrony parameters and systolic function parameters were acquired,including peak phase(PP),phase standard deviation(PSD),phase histogram bandwidth(PHB),histogram skewness(HS),histogram kurtosis(HK),and end-diastolic volume(EDV),end-systolic volume(ESV),left ventrieular ejection fraction(LVEF).All patients were divided into 4 groups:the normal group(147 cases),ischemic cardiomyopathy group(114 cases),nonischemic cardiomyopathy without left bundle branch block(LBBB)group(50 cases)and nonischemic cardiomyopathy with LBBB group(32 cases).The relationship between systolic synchrony parameters and systolic function parameters were analyzed with Pearson correlation analysis.Results Statistic results for all patients showed that PSD and PHB were well correlated with LVEF(r values:-0.790,-0.799,both P<0.01),but PP was poorly correlated with LVEF(r=-0.194,P<0.01);HS,HK were positively correlated with LVEF(r values:0.767,0.676,both P<0.01);PSD,PHB were positively correlated with ESV(r values:0.778,0.795,both P<0.01)and EDV(r values:0.722,0.732,both P<0.01);but PP was poorly correlated with ESV(r=0.145,P<0.01)and not correlated with EDV(r=0.095,P>0.01).HS,HK were negatively correlated with EDV and ESV(r values:-0.700 to-0.580,all P<0.01).PSD and PHB showed negatively correlation with LVEF(r values:-0.834 to-0.492,all P<0.01),while HS,HK showed positive correlation with LVEF(r values:0.243-0.792,all P<0.01)in normal group,the ischemic cardiomyopathy group,the nonischemic cardiomyopathy without LBBB group and the nonischemic cardiomyopathy with LBBB group.Conclusions The left ventricular systolic synchrony parameters provided by CZT SPECT GMPI correlate well with the left ventricular systolic function parameters,and the worse systolic function,the worse systolic synchrony.Both ischemic cardiomyopathy and non-ischemic cardiomyopathy can affect left ventricular mechanical contraction synchrony,and the effect on contraction synchrony in non-ischemic cardiomyopathy patients with LBBB is greater.