Assessment of myocardial perfusion with thallium-201 scintigraphy in exercise-induced left bundle branch block: Diagnostic value and clinical significance

G. La Canna, R. Giubbini, M. Metra, G. Arosio, A. Curnis, R. Cicogna, O. Visioli

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Myocardial perfusion scintigraphy with thallium-201 was performed in 33 subjects (mean age 45 years, range 28-61) with exercise-induced, rate-dependent left bundle branch block (LBBB) in order to assess both the value of Thallium-201 myocardial imaging for the diagnosis of coronary artery disease (CAD) and the pathogenesis (ischaemic or not) of the conduction defect. Of the 33 patients evaluated, 16 had chest pain suggestive of CAD and 17 were asymptomatic. None had a history of prior myocardial infarction or clinical and echocardiographic signs of heart disease. LBBB appeared at a heart rate ranging from 70 to 160 b .min-1. Eighteen patients showed repolarization abnormalities (ST segment depression with deep inverted T waves) compatible with ischaemia, after QRS normalization. Thallium-201 myocardial uptake was normal in 12 subjects; in the remaining 21, reversible Thallium-201 defects were demonstrated in the septum (18 patients), septum and apex (2), and septum and infero-apical wall (1). No patient had irreversible defects and all had normal coronary angiography, with negative ergonovine tests for coronary artery spasm. The patients were followed up for a mean of 43 months (range 16-80). One patient died from sudden death, but no cardiac event occurred in the other patients. In conclusion, exercise Thallium-201 myocardial scintigraphy showed a high prevalence (64%) of reversible perfusion defects in a group of patients with exercise-induced LBBB without any evidence of CAD at angiography or coronary spasm at ergonovine test. Moreover, follow-up showed a relatively low rate of major cardiac events.

Original languageEnglish
Pages (from-to)942-946
Number of pages5
JournalEuropean Heart Journal
Volume13
Issue number7
Publication statusPublished - 1992

Fingerprint

Thallium
Bundle-Branch Block
Coronary Artery Disease
Radionuclide Imaging
Exercise
Bundle
Diagnostics
Branch
Perfusion
Defects
Angiography
Cardiac
Repolarization
Ergonovine
Sudden Death
Myocardial Infarction
Myocardial Perfusion Imaging
Ischemia
Coronary Artery
Apex

Keywords

  • Coronary artery disease
  • Exercise-induced left bundle branch block
  • Thallium-201 scintigraphy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Statistics, Probability and Uncertainty
  • Applied Mathematics
  • Physiology (medical)
  • Physiology

Cite this

Assessment of myocardial perfusion with thallium-201 scintigraphy in exercise-induced left bundle branch block : Diagnostic value and clinical significance. / La Canna, G.; Giubbini, R.; Metra, M.; Arosio, G.; Curnis, A.; Cicogna, R.; Visioli, O.

In: European Heart Journal, Vol. 13, No. 7, 1992, p. 942-946.

Research output: Contribution to journalArticle

La Canna, G. ; Giubbini, R. ; Metra, M. ; Arosio, G. ; Curnis, A. ; Cicogna, R. ; Visioli, O. / Assessment of myocardial perfusion with thallium-201 scintigraphy in exercise-induced left bundle branch block : Diagnostic value and clinical significance. In: European Heart Journal. 1992 ; Vol. 13, No. 7. pp. 942-946.
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