Left ventricular dyssynchrony in patients with moderate coronary stenosis and border line fractional flow reserve

Yohei Shibata, Takahito Sone, Hideyuki Tsuboi, Satoshi Isobe, Hideki Ishii, Susumu Suzuki, Mutsuharu Hayashi, Toyoaki Murohara

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

The cutoff values of fractional flow reserve (FFR) to detect physiological myocardial ischemia are still controversial. Some studies have reported that left ventricular (LV) dyssynchrony occurs in patients with coronary artery disease (CAD). The purpose of this study was to investigate LV dyssynchrony in patients with moderate coronary stenosis and borderline FFR, using stress electrocardiographically-gated myocardial perfusion single-photon emission computed tomography (SPECT). The study population comprised 10 patients with moderate (50-75% diameter) stenosis and an FFR in the range 0.75-0.90, who were compared to 10 control subjects. All underwent stress myocardial 99mTc-sestamibi (MIBI) or tetrofosmin SPECT imaging. The regional time to end systole (TES), time to peak ejection (TPE), and time to peak filling (TPF) were obtained as indexes of perfusion and function, using gated SPECT (pFAST) in combination with Cardio Gated SPECT Regional Assessment for LV Function (cardioGRAF). The dyssynchrony index (DI) was also calculated. The DI of post-stress TES was significantly greater than that of rest in patients with moderate CAD (4.8 ± 2.8 vs. 2.7 ± 1.5, P = 0.01), but there were no significant differences in the control subjects (3.0 ± 1.7 vs. 2.9 ± 1.9, P = 0.99). There were no significant differences in TPE and TPF between the groups. In conclusion, LV dyssynchrony may occur after stress in patients with coronary stenosis and borderline FFR, even without a significant reduction in perfusion.

Original languageEnglish
Pages (from-to)155-166
Number of pages12
JournalNagoya journal of medical science
Volume77
Issue number1-2
Publication statusPublished - 01-01-2015
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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