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Dipyridamole stress myocardial perfusion by computed tomography in patients with left bundle branch block
BACKGROUND: Functional tests have limited accuracy for identifying myocardial ischemia in patients with left bundle branch block (LBBB). OBJECTIVE: To assess the diagnostic accuracy of dipyridamole-stress myocardial computed tomography perfusion (CTP) by 320-detector CT in patients with LBBB using i...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedade Brasileira de Cardiologia
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4693666/ https://www.ncbi.nlm.nih.gov/pubmed/26421532 http://dx.doi.org/10.5935/abc.20150117 |
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author | Cabeda, Estêvan Vieira Falcão, Andréa Maria Gomes Soares Jr., José Rochitte, Carlos Eduardo Nomura, César Higa Ávila, Luiz Francisco Rodrigues Parga, José Rodrigues |
author_facet | Cabeda, Estêvan Vieira Falcão, Andréa Maria Gomes Soares Jr., José Rochitte, Carlos Eduardo Nomura, César Higa Ávila, Luiz Francisco Rodrigues Parga, José Rodrigues |
author_sort | Cabeda, Estêvan Vieira |
collection | PubMed |
description | BACKGROUND: Functional tests have limited accuracy for identifying myocardial ischemia in patients with left bundle branch block (LBBB). OBJECTIVE: To assess the diagnostic accuracy of dipyridamole-stress myocardial computed tomography perfusion (CTP) by 320-detector CT in patients with LBBB using invasive quantitative coronary angiography (QCA) (stenosis ≥ 70%) as reference; to investigate the advantage of adding CTP to coronary computed tomography angiography (CTA) and compare the results with those of single photon emission computed tomography (SPECT) myocardial perfusion scintigraphy. METHODS: Thirty patients with LBBB who had undergone SPECT for the investigation of coronary artery disease were referred for stress tomography. Independent examiners performed per-patient and per-coronary territory assessments. All patients gave written informed consent to participate in the study that was approved by the institution’s ethics committee. RESULTS: The patients’ mean age was 62 ± 10 years. The mean dose of radiation for the tomography protocol was 9.3 ± 4.6 mSv. With regard to CTP, the per-patient values for sensitivity, specificity, positive and negative predictive values, and accuracy were 86%, 81%, 80%, 87%, and 83%, respectively (p = 0.001). The per-territory values were 63%, 86%, 65%, 84%, and 79%, respectively (p < 0.001). In both analyses, the addition of CTP to CTA achieved higher diagnostic accuracy for detecting myocardial ischemia than SPECT (p < 0.001). CONCLUSION: The use of the stress tomography protocol is feasible and has good diagnostic accuracy for assessing myocardial ischemia in patients with LBBB. |
format | Online Article Text |
id | pubmed-4693666 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Sociedade Brasileira de Cardiologia |
record_format | MEDLINE/PubMed |
spelling | pubmed-46936662016-01-04 Dipyridamole stress myocardial perfusion by computed tomography in patients with left bundle branch block Cabeda, Estêvan Vieira Falcão, Andréa Maria Gomes Soares Jr., José Rochitte, Carlos Eduardo Nomura, César Higa Ávila, Luiz Francisco Rodrigues Parga, José Rodrigues Arq Bras Cardiol Original Articles BACKGROUND: Functional tests have limited accuracy for identifying myocardial ischemia in patients with left bundle branch block (LBBB). OBJECTIVE: To assess the diagnostic accuracy of dipyridamole-stress myocardial computed tomography perfusion (CTP) by 320-detector CT in patients with LBBB using invasive quantitative coronary angiography (QCA) (stenosis ≥ 70%) as reference; to investigate the advantage of adding CTP to coronary computed tomography angiography (CTA) and compare the results with those of single photon emission computed tomography (SPECT) myocardial perfusion scintigraphy. METHODS: Thirty patients with LBBB who had undergone SPECT for the investigation of coronary artery disease were referred for stress tomography. Independent examiners performed per-patient and per-coronary territory assessments. All patients gave written informed consent to participate in the study that was approved by the institution’s ethics committee. RESULTS: The patients’ mean age was 62 ± 10 years. The mean dose of radiation for the tomography protocol was 9.3 ± 4.6 mSv. With regard to CTP, the per-patient values for sensitivity, specificity, positive and negative predictive values, and accuracy were 86%, 81%, 80%, 87%, and 83%, respectively (p = 0.001). The per-territory values were 63%, 86%, 65%, 84%, and 79%, respectively (p < 0.001). In both analyses, the addition of CTP to CTA achieved higher diagnostic accuracy for detecting myocardial ischemia than SPECT (p < 0.001). CONCLUSION: The use of the stress tomography protocol is feasible and has good diagnostic accuracy for assessing myocardial ischemia in patients with LBBB. Sociedade Brasileira de Cardiologia 2015-12 /pmc/articles/PMC4693666/ /pubmed/26421532 http://dx.doi.org/10.5935/abc.20150117 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Cabeda, Estêvan Vieira Falcão, Andréa Maria Gomes Soares Jr., José Rochitte, Carlos Eduardo Nomura, César Higa Ávila, Luiz Francisco Rodrigues Parga, José Rodrigues Dipyridamole stress myocardial perfusion by computed tomography in patients with left bundle branch block |
title | Dipyridamole stress myocardial perfusion by computed tomography in
patients with left bundle branch block |
title_full | Dipyridamole stress myocardial perfusion by computed tomography in
patients with left bundle branch block |
title_fullStr | Dipyridamole stress myocardial perfusion by computed tomography in
patients with left bundle branch block |
title_full_unstemmed | Dipyridamole stress myocardial perfusion by computed tomography in
patients with left bundle branch block |
title_short | Dipyridamole stress myocardial perfusion by computed tomography in
patients with left bundle branch block |
title_sort | dipyridamole stress myocardial perfusion by computed tomography in
patients with left bundle branch block |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4693666/ https://www.ncbi.nlm.nih.gov/pubmed/26421532 http://dx.doi.org/10.5935/abc.20150117 |
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