Comparison of regional myocardial blood flow and perfusion in dilated cardiomyopathy and left bundle branch block: role of wall thickening.

نویسندگان

  • Bernd Nowak
  • Christoph Stellbrink
  • Wolfgang M Schaefer
  • Anil M Sinha
  • Ole A Breithardt
  • Hans-Juergen Kaiser
  • Patrick Reinartz
  • Peter Hanrath
  • Ulrich Buell
چکیده

UNLABELLED Heterogeneous perfusion in left bundle branch block (LBBB) has been demonstrated by (99m)Tc-methoxyisobutylisonitrile (MIBI) SPECT. Locally different contraction is also associated with LBBB. Quantitative analysis of myocardial SPECT is influenced by partial-volume effects depending on systolic wall thickening. Therefore, partial-volume effects may mimic perfusion heterogeneity in LBBB. METHODS Fifteen patients with nonischemic dilated cardiomyopathy and LBBB underwent resting (15)O-water PET, (99m)Tc-MIBI SPECT, and gated (18)F-FDG PET for analysis of wall thickening. Myocardial blood flow corrected for rate-pressure product (corrMBF), (99m)Tc-MIBI uptake, and wall thickening were determined in 4 left ventricular wall areas. In 14 patients, M-mode echocardiographic recordings were available for comparison. RESULTS Homogeneous distribution was found for corrMBF (1.09 +/- 0.41 to 1.19 +/- 0.31 mL x g(-1) x min(-1)). (99m)Tc-MIBI uptake and wall thickening were heterogeneous (P < 0.0001), with the lowest values septal ((99m)Tc-MIBI, 65% +/- 10%; wall thickening, 16% +/- 14%) and the highest lateral ((99m)Tc-MIBI, 84% +/- 5%; wall thickening, 55% +/- 17%). Similar relationships in systolic wall thickening were observed by M-mode echocardiography (anteroseptal, 20% +/- 11%; posterolateral, 37% +/- 18%; P < 0.001). CONCLUSION Heterogeneity of (99m)Tc-MIBI uptake in LBBB corresponds to differences in wall thickening and does not reflect distribution of corrMBF. Supplementary analysis of wall thickening is recommended when assessing (99m)Tc-MIBI SPECT in LBBB.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Myocardial structural, perfusion, and metabolic correlates of left bundle branch block mechanical derangement in patients with dilated cardiomyopathy: a tagged cardiac magnetic resonance and positron emission tomography study.

BACKGROUND Left bundle branch block (LBBB) influences on regional left ventricular (LV) structure, perfusion, and metabolism have not yet been thoroughly investigated in dilated cardiomyopathy patients. METHODS AND RESULTS Eleven dilated cardiomyopathy patients with LBBB (mean+/-SD age, 62+/-11 years; LV ejection fraction, 35+/-8%) and 7 dilated cardiomyopathy patients without LBBB (mean+/-SD...

متن کامل

Gated 99mTc-MIBI myocardial perfusion SPECT in patients with right bundle branch block but without evidence of coronary artery disease

Introduction: We aimed to investigate the effect of right bundle branch block (RBBB) on perfusion and functional parameters in dipyridamole stress/rest Tc99m-MIBI gated myocardial perfusion SPECT (GSPECT) which may be helpful in interpretation of myocardial perfusion imaging. Methods: We studied 73 patients with low pre-test likelihood of coronary artery disease in two groups:  38 patients wit...

متن کامل

Myocardial Structural, Perfusion and Metabolic Correlates of Left Bundle Branch Block Mechanical Derangement in Patients with Dilated Cardiomyopathy: A Tagged Cardiac Magnetic Resonance and Positron Emission Tomography Study Running Title: Insights in LBBB Mechanisms by Multi-Imaging

Background – Left bundle branch block (LBBB) influences upon regional left ventricular (LV) structure, perfusion and metabolism were not thoroughly investigated in dilated cardiomyopathy (DCM) patients. Methods and Results – Eleven DCM patients with LBBB (69±11 years, LV ejection fraction[EF]: 35±8%) and 7 DMC patients without LBBB (58±9 years, LV EF: 37±10%) were studied by cardiac magnetic re...

متن کامل

Regional myocardial perfusion and glucose metabolism in experimental left bundle branch block.

BACKGROUND Several authors have reported cases in which 201Tl scintigraphy demonstrated perfusion abnormality in the septum of patients with left bundle branch block (LBBB) and normal coronary arteriogram. The mechanism of this abnormality, however, remains to be clarified. METHODS AND RESULTS To determine whether LBBB itself induces abnormal myocardial perfusion and ischemia and to elucidate...

متن کامل

Regional variation in myocardial blood flow in patients with left bundle branch block evaluated with quantitative perfusion CMR

Background This study is the first to use quantitative perfusion CMR to evaluate regional differences in myocardial blood flow (MBF) in patients with left bundle branch block (LBBB). LBBB is often associated with underlying CAD but its presence can limit the diagnostic accuracy of non-invasive imaging tests. In particular, there is a high incidence of false-positive results with exercise SPECT ...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Journal of nuclear medicine : official publication, Society of Nuclear Medicine

دوره 45 3  شماره 

صفحات  -

تاریخ انتشار 2004