Evaluation of left ventricular diastolic function with a dedicated cadmium-zinc-telluride cardiac camera: comparison with Doppler echocardiography

Eur Heart J Cardiovasc Imaging. 2014 Sep;15(9):972-9. doi: 10.1093/ehjci/jeu037. Epub 2014 Mar 11.

Abstract

Aims: To evaluate the relationships between measures of left ventricular (LV) filling dynamics at cadmium-zinc-telluride (CZT) imaging and indexes of LV diastolic function at transthoracic echocardiography.

Methods and results: Two hundred and forty-seven patients underwent myocardial perfusion imaging at rest and after stress with a low-dose CZT protocol and a baseline transthoracic echocardiography study. All patients were submitted to invasive or computed coronary angiography. The peak filling rate (PFR) and the time to PFR (TPFR) were derived from gated CZT images as measures of LV filling dynamics. LV diastolic function was also evaluated at echocardiography and the presence of significantly increased LV filling pressures determined. Increased LV filling pressures at transthoracic echocardiography were evident in 103 (42%) patients. Interestingly, independently from the presence of coronary artery disease, there was a strict correlation between the presence and severity of LV diastolic dysfunction at echocardiography and CZT-derived measures of filling dynamics, i.e., PFR (P = 0.001) and TPFR (P = 0.001). At receiving operating characteristic analysis, a composite index of reduced PFR (≤2.11 end-diastolic volume s(-1)) and increased TPFR (>234 ms) showed a sensitivity of 84% and a specificity of 67% in unmasking the presence of elevated LV filling pressures at echocardiography.

Conclusions: CZT-derived measures of LV filling dynamics correlate with echocardiographic parameters of diastolic function and may identify the presence of increased LV filling pressures.

Keywords: CZT; Diastolic function; Doppler echocardiography; Filling pressures; Peak filling rate.

MeSH terms

  • Aged
  • Cadmium
  • Coronary Angiography
  • Coronary Artery Disease / diagnostic imaging*
  • Echocardiography, Doppler
  • Exercise Test
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted
  • Male
  • Myocardial Perfusion Imaging / methods*
  • Organophosphorus Compounds
  • Organotechnetium Compounds
  • Radiopharmaceuticals
  • Tellurium
  • Ventricular Dysfunction, Left / diagnostic imaging*
  • Zinc

Substances

  • CdZnTe
  • Organophosphorus Compounds
  • Organotechnetium Compounds
  • Radiopharmaceuticals
  • Cadmium
  • technetium tc-99m tetrofosmin
  • Zinc
  • Tellurium