Publication:
Relationship Between Plasma Na Triuretic Peptide Level And Spect-derived Diastolic Parameters

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dc.contributor.authorZainal Rain Rancis, Siti Lenggogeni
dc.date.accessioned2026-04-15T07:22:47Z
dc.date.available2026-04-15T07:22:47Z
dc.date.issued2022
dc.description.abstractIntroduction: Diastolic dysfunction usually precedes systolic dysfunction and heart failure (HF). Patient with elevated natriuretic peptide such as N-Terminal pro Braintype Natriuretic Peptide (NT-proBNP) without failure symptoms and normal left ventricular ejection fraction (LVEF) may suffer from asymptomatic diastolic dysfunction which is categorized under stage B HF (pre-failure stage). Imaging technique for assessment of ventricular dysfunction (diastolic and systolic) usually performed using echocardiography. However, myocardial perfusion imaging using single photon emission computed tomography (SPECT) also can provide pertinent information on ventricular function such as LVEF for systolic function, ventricular peak filling rate (PFR), second PFR (PFR2), first third mean filling rate during diastole (1/3MFR), and time to PFR (TPFR or TTPF) for diastolic performance. Objectives: This study aims to assess the relationship of natriuretic peptide as ventricular biomarker and the diastolic parameters measured by electrocardiogram-gated myocardial perfusion SPECT (Gated MPS) among patient with normal LVEF and no evidence of myocardial ischaemia or infarction, and to analyse the association of SPECT-derived diastolic parameters with clinico-socio-demographic factors as well as to establish the centre-based reference value. Methods: We enrolled 137 patients with normal stress & rest myocardial perfusion and LVEF. The LV volume-filling curve was automatically calculated by Quantitative Gated SPECT (QGS) software using 16-frames list mode method to derive SPECT's diastolic parameters from rest study including PFR normalised to end diastolic volume (EDV), 1/3MFR normalised to EDV, TTPF (or TPFR) and TTPF normalised to R-R interval of cardiac cycle (TTPF/RR). The potential relationship with NT-proBNP, the association with clinico-socio-demographic factors and the reference values were studied. Results: The diastolic parameters by Gated MPS showed no correlation with NTproBNP. PFR and 1/3MFR were consistently reduced as level of NT-proBNP increases but not statistically significant (p=0.231 vs 0.348) and were influenced by age (p = 0.003 vs 0.002), diastolic blood pressure (p < 0.001 respectively) and hypertension (p = 0.031 vs 0.004). PFR had strong association with gender (p < 0.001) and heart rate (p <0.001) but not 1/3MFR. There was a statistically significant difference between diabetic and nondiabetic (p = 0.001); hypertensive and non-hypertensive (p =0.004) for 1/3MFR. Overall, only TTPF and TTPF/RR showed stable measurement with no influence observed with age, gender, blood pressure, heart rate and co-morbidities. The reference value of PFR, PFR2, 1/3MFR, TTPF and TTPF/RR as diastolic parameters were 1.55 ± 0.41, 0.70 ± 0.42, 0.79 ± 0.21, 333 ± 55 and 0.197 ± 0.044 respectively. Conclusion: Diastolic parameters measured by QGS 16-frame Gated MPS showed no relationship with ventricular biomarker; NT-proBNP. PFR, PFR2 and 1/3MFR were influenced by clinico-socio-demographic factors but not TTPF and TTPF/RR.
dc.identifier.urihttps://erepo.usm.my/handle/123456789/23926
dc.language.isoen
dc.subjectRelationship Between Plasma
dc.subjectSpect-derived Diastolic Parameters
dc.subjectSiti Lenggogeni
dc.subjectUniversiti Sains Malaysia
dc.subjectAMDI
dc.titleRelationship Between Plasma Na Triuretic Peptide Level And Spect-derived Diastolic Parameters
dc.typeResource Types::text::thesis::master thesis
dspace.entity.typePublication
oairecerif.author.affiliationUniversiti Sains Malaysia
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