Thallium-201 SPECT in coronary artery disease patients with left bundle branch block.
Fourteen patients with left bundle branch block (LBBB) underwent immediate postexercise and 3-hr delayed 201Tl single photon emission computed tomography (SPECT) with quantitative analysis using bullseye polar maps. Test performance in detecting individual coronary artery stenosis greater than or equal to 50% demonstrated 100% sensitivity. Specificity was 100% for circumflex stenosis, 78% for right coronary stenosis, but only 10% for left anterior descending coronary stenosis. This very low specificity was due to the fact that 3/4 (75%) patients with left anterior descending stenosis and also 9/10 (90%) patients with normal left anterior descending coronary arteries had immediate septal perfusion defects with redistribution in all cases at 3 hr. Septal abnormalities were most marked in patients who achieved high peak heart rates (greater than 170 bpm). Thus, with LBBB, 201Tl SPECT is indeterminate for left anterior descending coronary disease.
DePuey
E G
EG
Department of Radiology, Emory University School of Medicine, Atlanta, Georgia.
Guertler-Krawczynska
E
E
Robbins
W L
WL
D002037:Bundle-Branch Block / Q000150:complications / Q000000981:diagnostic imaging*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013794:Thallium Radioisotopes; D014055:Tomography, Emission-Computed / Q000379:methods*
D013794:Thallium Radioisotopes