To what extent are perfusion defects seen by myocardial perfusion SPECT in patients with left bundle branch block related to myocardial infarction, ECG characteristics, and myocardial wall motion?
Hedeer, Fredrik LU ; Ostenfeld, Ellen LU
; Hedén, Bo
LU
; Prinzen, Frits W.
; Arheden, Håkan
LU
; Carlsson, Marcus
LU
and Engblom, Henrik
LU
(2021)
In Journal of Nuclear Cardiology
28(6).
p.2910-2922
- Abstract
Introduction: We investigated if uptake pattern on myocardial perfusion SPECT (MPS) in patients with left bundle branch block (LBBB) is related to myocardial fibrosis, myocardial wall motion, and electrocardiography (ECG) characteristics. Methods: Twenty-three patients (9 women) with LBBB, examined with MPS and cardiac magnetic resonance (CMR), were included. Tracer uptake on MPS was classified by visual interpretation as typical LBBB pattern (Defect+, n = 13) or not (Defect−, n = 10) and quantitatively. CMR images were evaluated for wall thickness and for myocardial wall motion both by visual assessment and by regional myocardial radial strain from feature tracking, and for presence and location of myocardial fibrosis. ECGs were... (More)
Introduction: We investigated if uptake pattern on myocardial perfusion SPECT (MPS) in patients with left bundle branch block (LBBB) is related to myocardial fibrosis, myocardial wall motion, and electrocardiography (ECG) characteristics. Methods: Twenty-three patients (9 women) with LBBB, examined with MPS and cardiac magnetic resonance (CMR), were included. Tracer uptake on MPS was classified by visual interpretation as typical LBBB pattern (Defect+, n = 13) or not (Defect−, n = 10) and quantitatively. CMR images were evaluated for wall thickness and for myocardial wall motion both by visual assessment and by regional myocardial radial strain from feature tracking, and for presence and location of myocardial fibrosis. ECGs were analyzed regarding QRS duration and the presence of strict criteria for LBBB. Results: Wall thickness was slightly lower in the septum compared to the lateral wall in Defect+ patients (5.6 ± 1.1 vs 6.0 ± 1.3 mm, P = 0.03) but not in Defect− patients (5.6 ± 1.0 vs 5.6 ± 0.9 mm, P = 0.84). Defect+ patients showed a larger proportion of dyskinetic segments in the septum and hyperkinetic segments in the lateral wall compared to Defect− patients (P = 0.006 and P = 0.004, respectively). Decreased myocardial radial strain was associated with decreased tracer uptake by MPS (R = 0.37, P < 0.001). Areas of fibrosis did not match areas with uptake defect on MPS. No differences in ECG variables were seen. Conclusion: The heterogeneous regional tracer uptake in some patients with LBBB is related to underlying regional myocardial dyskinesia, wall thickening, and wall thickness rather than stress-induced ischemia, myocardial fibrosis, or specific ECG characteristics.
(Less)
- author
- Hedeer, Fredrik
LU
; Ostenfeld, Ellen
LU
; Hedén, Bo
LU
; Prinzen, Frits W.
; Arheden, Håkan
LU
; Carlsson, Marcus
LU
and Engblom, Henrik
LU
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- dyssynchrony, gated SPECT, MRI, physiology of LV/RV function, Physiology of myocardial/coronary perfusion, SPECT
- in
- Journal of Nuclear Cardiology
- volume
- 28
- issue
- 6
- pages
- 2910 - 2922
- publisher
- Springer
- external identifiers
-
- scopus:85085363937
- pmid:32451797
- ISSN
- 1071-3581
- DOI
- 10.1007/s12350-020-02180-7
- language
- English
- LU publication?
- yes
- id
- 017d67af-d238-4e1e-8392-8f17ed193922
- date added to LUP
- 2020-06-26 15:14:14
- date last changed
- 2024-06-26 17:46:13
@article{017d67af-d238-4e1e-8392-8f17ed193922,
abstract = {{<p>Introduction: We investigated if uptake pattern on myocardial perfusion SPECT (MPS) in patients with left bundle branch block (LBBB) is related to myocardial fibrosis, myocardial wall motion, and electrocardiography (ECG) characteristics. Methods: Twenty-three patients (9 women) with LBBB, examined with MPS and cardiac magnetic resonance (CMR), were included. Tracer uptake on MPS was classified by visual interpretation as typical LBBB pattern (Defect+, n = 13) or not (Defect−, n = 10) and quantitatively. CMR images were evaluated for wall thickness and for myocardial wall motion both by visual assessment and by regional myocardial radial strain from feature tracking, and for presence and location of myocardial fibrosis. ECGs were analyzed regarding QRS duration and the presence of strict criteria for LBBB. Results: Wall thickness was slightly lower in the septum compared to the lateral wall in Defect+ patients (5.6 ± 1.1 vs 6.0 ± 1.3 mm, P = 0.03) but not in Defect− patients (5.6 ± 1.0 vs 5.6 ± 0.9 mm, P = 0.84). Defect+ patients showed a larger proportion of dyskinetic segments in the septum and hyperkinetic segments in the lateral wall compared to Defect− patients (P = 0.006 and P = 0.004, respectively). Decreased myocardial radial strain was associated with decreased tracer uptake by MPS (R = 0.37, P < 0.001). Areas of fibrosis did not match areas with uptake defect on MPS. No differences in ECG variables were seen. Conclusion: The heterogeneous regional tracer uptake in some patients with LBBB is related to underlying regional myocardial dyskinesia, wall thickening, and wall thickness rather than stress-induced ischemia, myocardial fibrosis, or specific ECG characteristics.</p>}},
author = {{Hedeer, Fredrik and Ostenfeld, Ellen and Hedén, Bo and Prinzen, Frits W. and Arheden, Håkan and Carlsson, Marcus and Engblom, Henrik}},
issn = {{1071-3581}},
keywords = {{dyssynchrony; gated SPECT; MRI; physiology of LV/RV function; Physiology of myocardial/coronary perfusion; SPECT}},
language = {{eng}},
number = {{6}},
pages = {{2910--2922}},
publisher = {{Springer}},
series = {{Journal of Nuclear Cardiology}},
title = {{To what extent are perfusion defects seen by myocardial perfusion SPECT in patients with left bundle branch block related to myocardial infarction, ECG characteristics, and myocardial wall motion?}},
url = {{http://dx.doi.org/10.1007/s12350-020-02180-7}},
doi = {{10.1007/s12350-020-02180-7}},
volume = {{28}},
year = {{2021}},
}