title: Septal and anterior reverse mismatch of myocardial perfusion and metabolism in patients with coronary artery disease and left bundle branch block.
abstract: The effects of left bundle branch block (LBBB) on left ventricular myocardial metabolism have not been well investigated. This study evaluated these effects in patients with coronary artery disease (CAD).Sixty-five CAD patients with complete LBBB (mean age, 61.8 ± 9.7 years) and 65 without LBBB (mean age, 59.9 ± 8.4 years) underwent single photon emission computed tomography, positron emission tomography, and contrast coronary angiography. The relationship between myocardial perfusion and metabolism and reverse mismatch score, and that between QRS length and reverse mismatch score and wall motion score were evaluated.The incidence of left ventricular septum and anterior wall reverse mismatching between the two groups was significantly different (P < 0.001 and P = 0.002, respectively). The incidences of normal myocardial perfusion and metabolism in the left ventricular lateral and inferior walls were also significantly different between the two groups (P < 0.001 and P < 0.001, respectively). The incidence of septal reverse mismatching in patients with mild to moderate perfusion was significantly higher among those with LBBB than among those without LBBB (P < 0.001). In CAD patients with LBBB, septal reverse mismatching was significantly more common among those with mild to moderate perfusion than among those with severe perfusion defects (P = 0.002). The correlation between the septal reverse mismatch score and QRS length was significant (P = 0.026).In patients with CAD and LBBB, septal and anterior reverse mismatching of myocardial perfusion and metabolism was frequently present; the septal reverse mismatch score negatively correlated with the QRS interval.
authors.affiliation: From the Department of Nuclear Medicine (J-GW, WF, Y-QT, X-LZ, RS, X-XS, FG, D-YW, Z-XH, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College); and Department of Nuclear Medicine (M-FY), Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China.
authors.forename: Jian-Guang
authors.initials: JG
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Fang
authors.forename: Min-Fu
authors.initials: MF
authors.lastname: Yang
authors.forename: Yue-Qin
authors.initials: YQ
authors.lastname: Tian
authors.forename: Xiao-Li
authors.initials: XL
authors.lastname: Zhang
authors.forename: Rui
authors.initials: R
authors.lastname: Shen
authors.forename: Xiao-Xin
authors.initials: XX
authors.lastname: Sun
authors.forename: Feng
authors.initials: F
authors.lastname: Guo
authors.forename: Dao-Yu
authors.initials: DY
authors.lastname: Wang
authors.forename: Zuo-Xiang
authors.initials: ZX
authors.lastname: He
mesh_terms: D002037:Bundle-Branch Block / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D003326:Coronary Circulation / Q000502:physiology*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006352:Heart Ventricles / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D015899:Tomography, Emission-Computed, Single-Photon; D016277:Ventricular Function, Left / Q000502:physiology