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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Dipyridamole stress myocardial perfusion by computed tomography in patients with left bundle branch block

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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
[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 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