Original articleGated blood pool tomoscintigraphy with 4-dimensional optical flow motion analysis quantifies left ventricular mechanical activation and synchronization
Section snippets
Materials and methods
On the basis of a deformable motion estimation algorithm,10, 11 we developed a protocol allowing voxel-by-voxel estimation of motion fields after GBPT. We measured the mechanical activation times for the 17 LV segments (American Heart Association classification12) and determined the main types of activation pattern in normal subjects and in heart failure patients before and after multisite pacing.
Phase Analysis
Mechanical activation times are represented in Table 1. The intraventricular phase analysis showed a good correlation between 2D RNA and GBPT: r = 0.64 (P < .0001) for the apex-to-base time, r = 0.65 (P = .0003) for the inferior wall–to–anterior wall time, and r = 0.62 (P < .001) for the septum–to–lateral wall time.
Total Activation Time
An excellent correlation was obtained for the time differences between the peaks of the first and last segments in GBPT and the phase histogram width in 2D RNA (r = 0.82, P < .0001) (
Phase Analysis
In this investigation we demonstrate that 3D phase analysis can quantify LV synchronization. According to Scher,16 the sequence of ventricular activation reveals an early and almost simultaneous activation of the central left side of the septum and the high anterior and apicoposterior paraseptal LV areas, followed by the remainder of the septum and the LV and RV free walls. Our results, showing a twist motion of the left ventricle, with the anterior area, followed by the anterolateral area, the
Acknowledgment
The authors have indicated they have no financial conflicts of interest.
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