Prognostic value of left ventricular sphericity indexes using gated SPECT and echocardiography in heart failure: A prospective study

Articles in Press

Document Type : Original Article

Authors

1 Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Nuclear Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Cardiovascular Division, Vascular and Endovascular Surgery Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran

4 Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran

10.22034/irjnm.2025.130257.1705

Abstract

Introduction: Morphological remodeling of the heart during Heart failure (HF) can be detected by gated myocardial perfusion single-photon emission computed tomography (Gated SPECT) using left ventricular shape index (LVSI). This study aimed to investigate the prognostic value of LVSI measured by Gated SPECT and echocardiography in HF patients.
Methods: This prospective study involved 96 patients referred for myocardial perfusion scans, divided into two groups: those with heart failure (HF) and those without. The study analyzed cardiac sphericity indexes, including end-diastolic and end-systolic LVSI and the Eccentricity index (EI). The LVSI index was also measured by echocardiography at the end of diastole. The patients were followed for one year to evaluate the occurrence of cardiac events and underwent echocardiography at the end of this period.
Results: End-diastolic and end-systolic LVSI in the resting phase were 0.70±0.10 and 0.60±0.11 in the group of patients with HF, and 0.66±0.06 and 0.45±0.06 in the group of patients without heart failure, respectively. These values had a significant correlation with the similar index in echocardiography (p-value=0.001). In the group of HF patients, 20 people experienced cardiac events during one year of follow-up. However, there was no significant relationship between the values of LVSI measured by Gated SPECT and echocardiography and the incidence of cardiac events.
Conclusion: Although the values of LVSI in patients with HF were higher compared to those without HF, the indexes of heart shape change did not significantly predict the one-year prognosis of HF patients.

Keywords

Main Subjects

References

  1. Khan MS, Shahid I, Bennis A, Rakisheva A, Metra M, Butler J. Global epidemiology of heart failure. Nat Rev Cardiol. 2024 Oct;21(10):717-34.
  2. Li J, Liu S, Hu Y, Zhu L, Mao Y, Liu J. Predicting mortality in intensive care unit patients with heart failure using an interpretable machine learning model: retrospective cohort study. J Med Internet Res. 2022 Aug 9;24(8):e38082.
  3. Vancheri F, Longo G, Henein MY. Left ventricular ejection fraction: clinical, pathophysiological, and technical limitations. Front Cardiovasc Med. 2024 Feb 7;11:1340708.
  4. Martínez-Lucio TS, Alexánderson-Rosas E, Carvajal-Juárez I, Mendoza-Ibáñez AK, Mendoza-Ibáñez OI, Monroy-Gonzalez AG, Peterson BW, Tsoumpas C, Slart RHJA. Left ventricular shape index and eccentricity index with ECG-gated Nitrogen-13 ammonia PET/CT in patients with myocardial infarction, ischemia, and normal perfusion. J Nucl Cardiol. 2024 Jun;36:101862.
  5. Gjesdal O, Bluemke DA, Lima JA. Cardiac remodeling at the population level--risk factors, screening, and outcomes. Nat Rev Cardiol. 2011 Oct 25;8(12):673-85.
  6. Lieb W, Gona P, Larson MG, Aragam J, Zile MR, Cheng S, Benjamin EJ, Vasan RS. The natural history of left ventricular geometry in the community: clinical correlates and prognostic significance of change in LV geometric pattern. JACC Cardiovasc Imaging. 2014 Sep;7(9):870-8.
  7. Yu CM, Fung WH, Lin H, Zhang Q, Sanderson JE, Lau CP. Predictors of left ventricular reverse remodeling after cardiac resynchronization therapy for heart failure secondary to idiopathic dilated or ischemic cardiomyopathy. Am J Cardiol. 2003 Mar 15;91(6):684-8.
  8. Azevedo PS, Polegato BF, Minicucci MF, Paiva SA, Zornoff LA. Cardiac remodeling: concepts, clinical impact, pathophysiological mechanisms and pharmacologic treatment. Arq Bras Cardiol. 2016 Jan;106(1):62-9.
  9. Li T, Li G, Guo X, Li Z, Sun Y. Echocardiographic left ventricular geometry profiles for prediction of stroke, coronary heart disease and all-cause mortality in the Chinese community: a rural cohort population study. BMC Cardiovasc Disord. 2021 May 12;21(1):238.
  10. Barbieri A, Albini A, Maisano A, De Mitri G, Camaioni G, Bonini N, Mantovani F, Boriani G. Clinical value of complex echocardiographic left ventricular hypertrophy classification based on concentricity, mass, and volume quantification. Front Cardiovasc Med. 2021 Apr 27;8:667984.
  11. Losi MA, Imbriaco M, Canciello G, Pacelli F, Di Nardo C, Lombardi R, Izzo R, Mancusi C, Ponsiglione A, Dell'Aversana S, Cuocolo A, de Simone G, Trimarco B, Barbato E. Left ventricular mass in hypertrophic cardiomyopathy assessed by 2D-echocardiography: validation with magnetic resonance imaging. J Cardiovasc Transl Res. 2020 Apr;13(2):238-44.
  12. Nitta K, Kurisu S, Erasta R, Sumimoto Y, Ikenaga H, Ishibashi K, Fukuda Y, Kihara Y. Associations of left ventricular shape with left ventricular volumes and functions assessed by ECG-gated SPECT in patients without significant perfusion abnormality. Heart Vessels. 2020 Jan;35(1):86-91
  13. Knott KD, Camaioni C, Ramasamy A, Augusto JA, Bhuva AN, Xue H, Manisty C, Hughes RK, Brown LAE, Amersey R, Bourantas C, Kellman P, Plein S, Moon JC. Quantitative myocardial perfusion in coronary artery disease: a perfusion mapping study. J Magn Reson Imaging. 2019 Sep;50(3):756-62.
  14. Germano G, Kiat H, Kavanagh PB, Moriel M, Mazzanti M, Su HT, Van Train KF, Berman DS. Automatic quantification of ejection fraction from gated myocardial perfusion SPECT. J Nucl Med. 1995 Nov;36(11):2138-47.
  15. McKee PA, Castelli WP, McNamara PM, Kannel WB. The natural history of congestive heart failure: the Framingham study. N Engl J Med. 1971 Dec 23;285(26):1441-6.
  16. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2015 Mar;16(3):233-70.
  17. Abidov A, Slomka PJ, Nishina H, Hayes SW, Kang X, Yoda S, Yang LD, Gerlach J, Aboul-Enein F, Cohen I, Friedman JD, Kavanagh PB, Germano G, Berman DS. Left ventricular shape index assessed by gated stress myocardial perfusion SPECT: initial description of a new variable. J Nucl Cardiol. 2006 Sep;13(5):652-9.
  18. Nappi C, Gaudieri V, Acampa W, Assante R, Zampella E, Mainolfi CG, Petretta M, Germano G, Cuocolo A. Comparison of left ventricular shape by gated SPECT imaging in diabetic and nondiabetic patients with normal myocardial perfusion: A propensity score analysis. J Nucl Cardiol. 2018 Apr;25(2):394-403.
  19. Hämäläinen H, Laitinen TM, Hedman M, Hedman A, Kivelä A, Laitinen TP. Cardiac remodelling in association with left ventricular dyssynchrony and systolic dysfunction in patients with coronary artery disease. Clin Physiol Funct Imaging. 2022 Nov;42(6):413-21.
  20. Gaudieri V, Nappi C, Acampa W, Zampella E, Assante R, Mannarino T, Genova A, De Simini G, Klain M, Germano G, Petretta M, Cuocolo A. Added prognostic value of left ventricular shape by gated SPECT imaging in patients with suspected coronary artery disease and normal myocardial perfusion. J Nucl Cardiol. 2019 Aug;26(4):1148-56.
  21. Zhao Y, Hu Y, Li Y, Wang Y, Xiao Y, Xu L, Ren T, Wu Q, Wang R, Wu Z, Li S, Wu P. Spherization indices measured by resting SPECT improve risk stratification in patients with ischemia with non-obstructive coronary artery disease (INOCA). EJNMMI Res. 2024 Feb 7;14(1):16.
  22. Wu P, Zhao Y, Guo X, Liu X, Hu Y, Xiao Y, Xu L, Huang N, Li Y, Wang Y, Ren T, Wu Q, Wang R, Zhang X, Wu Z, Li S. Prognostic value of resting left ventricular sphericity indexes in coronary artery disease with preserved ejection fraction. J Am Heart Assoc. 2024 Sep 3;13(17):e032169.
  23. Malagoli A, Rossi L, Bursi F, Zanni A, Sticozzi C, Piepoli MF, Villani GQ. Left atrial function predicts cardiovascular events in patients with chronic heart failure with reduced ejection fraction. J Am Soc Echocardiogr. 2019 Feb;32(2):248-56.
  24. Cheng YJ, Liao ZL, Liu LJ, Ma YD, Chen XM, Wu ZX, Wei HQ, Lin WD, Liao YJ, Wu SH, Xue YM, Wang LC, Wu Y. Association between size of left ventricle and long-term cardiovascular events. J Am Heart Assoc. 2025 Aug 5;14(15):e040490.
  25. Zhang Z, Fang X, Liu C, Wang C, Liu H, Lu W, Guan S, Li H, Liu C, Fan S, Yang Y. Ejection fraction indexed to left ventricular mass and its association with cardiac event risk in a community population with mildly reduced or preserved ejection fraction. J Am Heart Assoc. 2025 Jun 17;14(12):e038777.
  26. Bigdeloo L, Dabbagh Kakhki VR, Ghaderi F, Peyvandi L., Ghahremani S, Atar B. Diastolic left ventricular functional indices: comparison between gated myocardial perfusion SPECT and echocardiography. Iran J Nucl Med. 2019; 27(1):15-8.
  27. Kurisu S, Sumimoto Y, Ikenaga H, Watanabe N, Ishibashi K, Dohi Y, Fukuda Y, Kihara Y. Comparison of 8-frame and 16-frame thallium-201 gated myocardial perfusion SPECT for determining left ventricular systolic and diastolic parameters. Heart Vessels. 2017 Jul;32(7):790-795.
  28. Korkmaz AN, Caliskan B, Erdem F. Evaluation of Diastolic Function in Patients with Normal Perfusion and Type 2 Diabetes Mellitus with Gated Single-photon Emission Computed Tomography. World J Nucl Med. 2017 Jul-Sep;16(3):206-211.
Iranian Journal of Nuclear Medicine

Articles in Press, Accepted Manuscript
Available Online from 28 December 2025

Files

Share

How to cite

Statistics