[Results of myocardial scintigraphy in patients with left bundle-branch block using Tl-201 and Tc-99m-MIBI].
Tl-201 myocardial scintigrams in patients with left bundle-branch block (LBBB) are frequently non-diagnostic with respect to presence or absence of coronary artery disease (CAD). The new myocardial perfusion tracer Tc-99m-MIBI requires a different protocol due to its insignificant redistribution. Therefore, scintigraphic patterns in LBBB cannot be deduced from experiences with Tl-201. In a total of 132 patients with LBBB, 81 studies were carried out with Tl-201, another 81 studies with Tc-99m-MIBI. In 30 patients both radiopharmaceuticals were employed. 72% of the Tl-201 scintigraphies in constant LBBB resulted in a reversible septal deficit and 9% in a constant septal deficit. In contrast, 70% of the Tc-99m-MIBI scintigraphies resulted in a constant septal deficit and only 19% in a reversible septal deficit. Similar "discrepancies" were found in LBBB patients in whom CAD has been angiographically excluded (N = 17). All patients, however, with LAD or RCA stenoses and constant LBBB showed reversible septal deficits with either tracer, Tl-201 (N = 12) or Tc-99m-MIBI (N = 10). It is concluded: 1) that the majority of patients with LBBB has reduced septal perfusion, 2) that this reduction is typically stress-independent in absence of CAD, and 3) that this stress-independent perfusion deficit is, in general, only differentiated from stress-induced ischemia (in case of CAD) with using the Tc-99m-MIBI protocol.
Knapp
W H
WH
Institut für Nuklearmedizin, Herzzentrum NRW, Universitätsklinik, Ruhr-Universität Bochum.
Schmidt
U
U
Bentrup
A
A
Notohamiprodjo
G
G
Gleichmann
U
U
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002037:Bundle-Branch Block / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging; D005080:Exercise Test; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008875:Middle Aged; D009570:Nitriles; D015609:Organotechnetium Compounds; D017256:Technetium Tc 99m Sestamibi; D013794:Thallium Radioisotopes; D014055:Tomography, Emission-Computed
D009570:Nitriles; D015609:Organotechnetium Compounds; D013794:Thallium Radioisotopes; D017256:Technetium Tc 99m Sestamibi
Ergebnisse der Myokardszintigraphie mit Tl-201 und Tc-99m-MIBI bei Patienten mit Linksschenkelblock.