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Titolo:
Perfusion and functional abnormalities outside the septal region in patients with left bundle branch block assessed with gated SPECT
Autore:
Bavelaar-Croon, CDL; Wahba, FFMF; Van Hecke, MV; Atsma, DE; Stokkel, MPM; Pauwels, EKJ; Van der Wall, EE;
Indirizzi:
Leiden Univ, Med Ctr, Div Nucl Med, Leiden, Netherlands Leiden Univ Leiden Netherlands d Ctr, Div Nucl Med, Leiden, Netherlands Leiden Univ, Med Ctr, Dept Radiol, Leiden, Netherlands Leiden Univ Leiden Netherlands ed Ctr, Dept Radiol, Leiden, Netherlands Leiden Univ, Med Ctr, Dept Cardiol, Leiden, Netherlands Leiden Univ Leiden Netherlands d Ctr, Dept Cardiol, Leiden, Netherlands
Titolo Testata:
QUARTERLY JOURNAL OF NUCLEAR MEDICINE
fascicolo: 1, volume: 45, anno: 2001,
pagine: 108 - 114
SICI:
1125-0135(200103)45:1<108:PAFAOT>2.0.ZU;2-1
Fonte:
ISI
Lingua:
ENG
Soggetto:
EMISSION COMPUTED-TOMOGRAPHY; WALL-MOTION; VENTRICULAR-FUNCTION; EJECTION FRACTION; DOBUTAMINE STRESS; QUANTITATION; QUANTIFICATION; SCINTIGRAPHY;
Keywords:
tomography emission computed, single photon; gated blood pool imaging; ventricular function, left; bundle branch block; heart radionuclide imaging;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
19
Recensione:
Indirizzi per estratti:
Indirizzo: Pauwels, EKJ Leiden Univ, Med Ctr, Dept Nucl Med, C4-Q,Albinusdreef 2, NL-233 ZA Leiden, Netherlands Leiden Univ C4-Q,Albinusdreef 2 Leiden Netherlands NL-233 ZA
Citazione:
C.D.L. Bavelaar-Croon et al., "Perfusion and functional abnormalities outside the septal region in patients with left bundle branch block assessed with gated SPECT", Q J NUCL M, 45(1), 2001, pp. 108-114

Abstract

Background. The presence of a left bundle branch block (LBBB) pattern on the electrocardiogram may frequently lead to perfusion defects in the septumnot necessarily due to ischemic heart disease, but probably due to abnormal septal wall motion. The introduction of gated single photon emission computed tomography (SPECT) allows the evaluation of myocardial perfusion and function in one study. Accordingly, we analysed perfusion and function and the relation between perfusion and regional function in the septal region inpatients with a LBBB without evidence of a previously sustained myocardialinfarction. Methods. We selected 37 patients with a LBBB without a history of a previous myocardial infarction, which was confirmed by echocardiography and/or coronary angiography. Ah patients underwent technetium-99m tetrofosmin gated SPECT myocardial imaging. Twelve control patients with a low likelihood of coronary artery disease and a normal technetium-99m tetrofosmin gated SPECTmyocardial perfusion scintigram were selected as a reference population. The left ventricle (LV) was divided into 18 segments, which were scored for perfusion and function (wall motion and wall thickening) on a 4-point scale. Results. The average LV end-diastolic volume was higher and the average LVejection fraction was lower in patients with LBBB as compared to controls (142 +/- 90 vs. 81 +/- 18 ml, and 48 +/- 13 vs 62 +/-7%, p=0.03 and p=0.02,respectively). Not only in the septum, but also in the other segments, reduced myocardial perfusion and abnormal wall motion/wall thickening was observed in the patients with LBBB (p <0.0001 vs controls). Patients with LBBB showed no correlation between perfusion and function in the septum, and between perfusion in septum and global LV function (r=0.21, p=0.2; r=0.10, p=0.6, respectively). Conversely, a good correlation was found between perfusion and function, either regional or global, in the remote segments (both r=0.79, p <0.0001). Conclusions. We conclude that patients with LBBB without a previous myocardial infarction show cardiomyopathic changes with perfusion and wall motionabnormalities, involving the entire left ventricle. The severity of diminished septal perfusion is not directly associated with the severity of septal wall motion abnormalities or global LV function. However, in the myocardial segments remote from the septum, reduced perfusion is closely associatedwith functional abnormalities.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 18:59:30