Myocardial perfusion SPECT identifies patients with left bundle branch block patterns at high risk for future coronary events

• Published in: Journal of nuclear cardiology 2010-04, Vol.17 (2), p.216-224
• Main Authors: ten Cate, Tim J. F., Kelder, Johannes C., Plokker, Herbert W. M., Fred Verzijlbergen, J., van Hemel, Norbert M.
• Format: Article
• Language: English
• Subjects: Aged; Bundle-Branch Block - diagnosis; Bundle-Branch Block - diagnostic imaging; Cardiology; Coronary Artery Disease - diagnosis; Coronary Artery Disease - diagnostic imaging; Female; Humans; Image Processing, Computer-Assisted; Imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Myocardium - pathology; Nuclear Medicine; Original Article; Perfusion; Prognosis; Radiology; Retrospective Studies; Time Factors; Tomography, Emission-Computed, Single-Photon - methods; Treatment Outcome; Vasodilator Agents
• ISSN: 1071-3581; 1532-6551
• DOI: 10.1007/s12350-009-9183-9

Background The value of myocardial perfusion SPECT (MPS) for patients with left bundle branch block (LBBB) or right ventricular apical (RVA) pacing seems reduced. The prognosis of patients with only abnormal activation related perfusion defects (AARD) due to LBBB or RVA-pacing is similar to those with a normal MPS. We assessed the prognostic value of MPS in patients with LBBB or RVA pacing. Methods Patients with LBBB or RVA pacing referred for vasodilator stress MPS between April 2002 and January 2006 were analyzed. Group 1 are patients with normal MPS and MPS with AARD. Group 2 are patients with an MPS with a perfusion defect extending outside the AARD area. Events were cardiac death, acute myocardial infarction and coronary revascularization. Results In Group 1 (101 patients) 12 events and in Group 2 (96 patients) 45 events occurred during a mean follow-up of 2.6 ± 1.5 years. The prognosis of Group 2 was significantly worse (49%) compared with Group 1 (91%). The annual cardiac death rate was 0.7%/year in Group 1 and 6.4%/year in Group 2 ( P