TL-201 SPECT IN CORONARY-ARTERY DISEASE PATIENTS WITH LEFT-BUNDLE BRANCH-BLOCK

  • 1 September 1988
    • journal article
    • research article
    • Vol. 29  (9) , 1479-1485
Abstract
Fourteen patients with left bundle branch block (LBBB) underwent immediate postexercise and 3-hr delayed 201Tl single photon emission computed tomography (SPECT) with quantitative analysis using bullseye polar maps. Test performance in detecting individual coronary artery stenosis .gtoreq. 50% demonstrated 100% sensitivity. Specificity was 100% for circumflex stenosis, 78% for right coronary stenosis, but only 10% for left anterior descending coronary stenosis. This very low specificity was due to the fact that 3/4 (75%) patients with left anterior descending stenosis and also 9/10 (90%) patients with normal left anterior descending coronary arteries had immediate septal perfusion defects with redistribution in all cases at 3 hr. Septal abnormalities were most marked in patients who achieved high peak heart rates (> 170 bpm). Thus, with LBBB, 201Tl SPECT is indeterminate for left anterior descending coronary disease.