[Myocardial perfusion study in patients with right bundle branch block].
OBJECTIVE
To evaluate the sensitivity and specificity of myocardial perfusion scintigraphy in the detection of coronary artery disease in patients with right bundle branch block (RBBB).


METHODS
Thirty one patients (24 male, 62.3 +/- 10.5 years) with RBBB, submitted to myocardial perfusion scintigraphy associated with exercise (n = 7) or dipyridamole (n = 24) and previous cinecoronariography were studied retrospectively. Left ventricle scintigraphic image was divided in three segments corresponding to the three main epicardic coronary territories in a total of 93 segments. Cineangiographic and scintigraphic data were then compared according to the different artery territories.


RESULTS
Twenty three patients had significant lesions (> or = 60%) in one or more coronary arteries and eight had no obstruction. Forty nine segments were irrigated by normal coronary arteries and 44 were related to arteries that had significant lesions. Twenty out of twenty three patients showed alterations in perfusion (sensitivity = 87%). All patients without coronary obstructions showed normal perfusion scintigraphy (specificity = 100%). One of the segments perfused by normal coronaries showed abnormal scintigraphy. Scintigraphy showed perfusion defects in 29 out of 44 segments with coronary obstructions. Sensitivity and specificity of the method for each arterial territory were 72% and 100% (left descending coronary artery), 67% and 94% (right coronary artery), 55% and 100% (circunflex coronary artery), respectively.


CONCLUSIONS
The presence of RBBB does not modify the sensitivity and specificity of the method in the detection of coronary artery disease.
de Paula
R L
RL
Instituto do Coração do Hospital das Clínicas, FMUSP.
Giorgi
M C
MC
Soares Júnior
J
J
Moraes
A P
AP
Izaki
M
M
Cerri
G G
GG
Pileggi
F
F
Meneghetti
J C
JC
D002037:Bundle-Branch Block / Q000150:complications* / Q000000981:diagnostic imaging; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000209:etiology; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity