ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2021
To what extent are perfusion defects seen by myocardial perfusion SPECT in patients with left bundle branch block related to myocardial infarction, ECG characteristics, and myocardial wall motion?
Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed.
- CMR characterization of patients with heart failure and left bundle branch block.European heart journal. Imaging methods and practice · 2024Article
- Detection and quantification of myocardial scar and LVEF with high efficiency digital SPECT: The expanding value proposition for clinical cardiology.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Diagnostic accuracy for CZT gamma camera compared to conventional gamma camera technique with myocardial perfusion single-photon emission computed tomography: Assessment of myocardial infarction and function.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- QRS Fragmentation in Preserved Ejection Fraction Heart Failure: Functional Insights, Pathological Correlates, and Prognosis.Journal of the American Heart Association · 2023Article
- Diagnostic value of myocardial stress detection based on feature tracking MRI in patients with acute myocardial infarction.Journal of thoracic disease · 2022Article
- Elucidating the pathophysiology of left bundle branch block related perfusion defects.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Article
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Abstract
introductionWe investigated if uptake pattern on myocardial perfusion SPECT (MPS) in patients with left bundle branch block (LBBB) is related to myocardial fibrosis, myocardial wall motion, and electrocardiography (ECG) characteristics.
methodsTwenty-three patients (9 women) with LBBB, examined with MPS and cardiac magnetic resonance (CMR), were included. Tracer uptake on MPS was classified by visual interpretation as typical LBBB pattern (Defect+, n = 13) or not (Defect-, n = 10) and quantitatively. CMR images were evaluated for wall thickness and for myocardial wall motion both by visual assessment and by regional myocardial radial strain from feature tracking, and for presence and location of myocardial fibrosis. ECGs were analyzed regarding QRS duration and the presence of strict criteria for LBBB.
resultsWall thickness was slightly lower in the septum compared to the lateral wall in Defect+ patients (5.6 ± 1.1 vs 6.0 ± 1.3 mm, P = 0.03) but not in Defect- patients (5.6 ± 1.0 vs 5.6 ± 0.9 mm, P = 0.84). Defect+ patients showed a larger proportion of dyskinetic segments in the septum and hyperkinetic segments in the lateral wall compared to Defect- patients (P = 0.006 and P = 0.004, respectively). Decreased myocardial radial strain was associated with decreased tracer uptake by MPS (R = 0.37, P < 0.001). Areas of fibrosis did not match areas with uptake defect on MPS. No differences in ECG variables were seen.
conclusionThe heterogeneous regional tracer uptake in some patients with LBBB is related to underlying regional myocardial dyskinesia, wall thickening, and wall thickness rather than stress-induced ischemia, myocardial fibrosis, or specific ECG characteristics.
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