| Full text | |
| Author(s): |
Cabeda, Estevan Vieira
[1]
;
Gomes Falcao, Andrea Maria
[2]
;
Soares, Jr., Jose
[2]
;
Rochitte, Carlos Eduardo
[1]
;
Nomura, Cesar Higa
[1]
;
Rodrigues Avila, Luiz Francisco
[1]
;
Parga, Jose Rodrigues
[1]
Total Authors: 7
|
| Affiliation: | [1] Univ Sao Paulo, Inst Coracao InCor, Dept Tomog & Ressonancia Cardiovasc, BR-09500900 Sao Paulo, SP - Brazil
[2] Univ Sao Paulo, Inst Coracao InCor, Dept Nucl Med, BR-09500900 Sao Paulo, SP - Brazil
Total Affiliations: 2
|
| Document type: | Journal article |
| Source: | Arquivos Brasileiros de Cardiologia; v. 105, n. 6, p. 614-624, DEC 2015. |
| Web of Science Citations: | 0 |
| Abstract | |
Abstract 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. (AU) | |
| FAPESP's process: | 10/15584-0 - Research for coronary artery disease in patients with left bundle branch block: a new paradigm for coronary CT angiography multidetector row by anatomical and perfusion evaluation |
| Grantee: | José Rodrigues Parga Filho |
| Support Opportunities: | Regular Research Grants |