Association between left ventricular regional sympathetic denervation and mechanical dyssynchrony in phase analysis: A cardiac CZT study

Alessia Gimelli, Riccardo Liga, Dario Genovesi, Assuero Giorgetti, Annette Kusch, Paolo Marzullo

Research output: Contribution to journalArticle


Purpose: To evaluate the relationships among myocardial sympathetic innervation, perfusion and mechanical synchronicity assessed with cardiac cadmium-zinc-telluride (CZT) scintigraphy. Methods: A group of 29 patients underwent an evaluation of myocardial perfusion with 99mTc- tetrofosmin CZT scintigraphy and adrenergic innervation with 123I-metaiodobenzylguanidine (MIBG) CZT scintigraphy. The summed rest score (SRS), motion score (SMS) and thickening score (STS), as well as the summed 123I-MIBG defect score (SS-MIBG), were determined. Regional tracer uptake for both 99mTc-tetrofosmin and 123I-MIBG was also calculated. Finally, the presence of significant myocardial mechanical dyssynchrony was evaluated in phase analysis on gated CZT images and the region of latest mechanical activation identified. Results: Significant mechanical dyssynchrony was present in 17 patients (59 %) and associated with higher SRS (P=0.030), SMS (P123I-MIBG uptake (P=0.012) that overwhelmed the effect of depressed regional perfusion. Conclusion: Left ventricular mechanical dyssynchrony is associated with greater depression in contractile function and greater impairments in regional myocardial perfusion and sympathetic activity. In patients with dyssynchrony, the region of latest mechanical activation is characterized by a significantly altered adrenergic tone.

Original languageEnglish
Pages (from-to)946-955
Number of pages10
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Issue number5
Publication statusPublished - 2014



  • CZT
  • Mechanical dyssynchrony
  • Phase analysis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

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