Prognosis in patients with left bundle branch block and normal dipyridamole thallium-201 scintigraphy.
BACKGROUND
The presence of complete left bundle branch block (LBBB) is commonly associated with a poorer prognosis, especially in patients with coronary artery disease (CAD). In the general population with suspected CAD and normal intraventricular conduction, a normal dipyridamole-thallium scintigraphy is a strong marker of a favorable outcome.


OBJECTIVE
Our objective was to assess the prognosis in patients with LBBB and a normal dipyridamole thallium-201 scintigram.


METHODS
Patients with complete LBBB and normal myocardial perfusion on dipyridamole SPECT thallium-201 scintigraphy performed in our center for suspected CAD between 1988 and 1995 were monitored for clinical events.


RESULTS
Sixty-nine patients (36 women and 33 men) with a mean age of 59 years (range 56 to 61) were monitored for a mean period of 33 months (range 25 to 35). During this period, 4 patients had unstable angina, 2 of whom underwent myocardial revascularization. There were no deaths or myocardial infarction. All events occurred at least 2 years after the thallium-201 scintigraphy.


CONCLUSIONS
The presence of a normal myocardial perfusion with dipyridamole thallium-201 scintigraphy in this group of patients with suspected CAD and LBBB was associated with a very good prognosis, a low rate of clinical events occurring only 2 years after the myocardial scintigraphy, and no hard events.
Department of Nuclear Medicine, Hospital de Santa Cruz and Instituto do Coração, Carnaxide, Portugal.
V M
VM
Gil
M
M
Almeida
A
A
Ventosa
J
J
Ferreira
C
C
Aguiar
J
J
Calqueiro
R
R
Seabra-Gomes
D002037:Bundle-Branch Block / Q000000981:diagnostic imaging*; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D004176:Dipyridamole; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D013794:Thallium Radioisotopes; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon; D014665:Vasodilator Agents
D013794:Thallium Radioisotopes; D014665:Vasodilator Agents; D004176:Dipyridamole