Myocardial blood flow assessment with 82rubidium-PET imaging in patients with left bundle branch block

Autor(es)

Andréa Falcão ^[1] ; William Chalela ^[2] ; Maria Clementina Giorgi ^[3] ; Rodrigo Imada ^[4] ; José Soares Jr ^[5] ; Renata Do Val ^[6] ; Marco Antonio Oliveira ^[7] ; Marisa Izaki ^[8] ; Roberto Kalil Kalil Filho ^[9] ; José C. Meneghetti ^[10]

Afiliação do(s) autor(es)

^[1] Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Serviço de Medicina Nuclear e Imagem Molecular - Brasil

^[2] Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Serviço de Medicina Nuclear e Imagem Molecular - Brasil

^[3] Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Serviço de Medicina Nuclear e Imagem Molecular - Brasil

^[4] Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Serviço de Medicina Nuclear e Imagem Molecular - Brasil

^[5] Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Serviço de Medicina Nuclear e Imagem Molecular - Brasil

^[6] Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Serviço de Medicina Nuclear e Imagem Molecular - Brasil

^[7] Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Serviço de Medicina Nuclear e Imagem Molecular - Brasil

^[8] Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Serviço de Medicina Nuclear e Imagem Molecular - Brasil

^[9] Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Serviço de Medicina Nuclear e Imagem Molecular - Brasil

^[10] Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Serviço de Medicina Nuclear e Imagem Molecular - Brasil

• Tipo de documento: Artigo Científico
• Fonte: Clinics; v. 70, n. 11, p. 726-732, 2015-11-00.

Resumo

OBJECTIVES: Perfusion abnormalities are frequently seen in Single Photon Emission Computed Tomography (SPECT) when a left bundle branch block is present. A few studies have shown decreased coronary flow reserve in the left anterior descending territory, regardless of the presence of coronary artery disease. OBJECTIVE: We sought to investigate rubidium-82 (82Rb) positron emission tomography imaging in the assessment of myocardial blood flow and coronary flow reserve in patients with left bundle branch block. METHODS: Thirty-eight patients with left bundle branch block (GI), median age 63.5 years, 22 (58%) female, 12 with coronary artery disease (≥70%; GI-A) and 26 with no evidence of significant coronary artery disease (GI-B), underwent rest-dipyridamole stress 82Rb-positron emission tomography with absolute quantitative flow measurements using Cedars-Sinai software (mL/min/g). The relative myocardial perfusion and left ventricular ejection fraction were assessed in 17 segments. These parameters were compared with those obtained from 30 patients with normal 82Rb-positron emission tomography studies and without left bundle branch block (GII). RESULTS: Stress myocardial blood flow and coronary flow reserve were significantly lower in GI than in GII (p<0.05). The comparison of coronary flow reserve between GI-A and GI-B showed that it was different from the global coronary flow reserve (p<0.05) and the stress flow was significantly lower in the anterior than in the septal wall for both groups. Perfusion abnormalities were more prevalent in GI-A (p=0.06) and the left ventricular ejection fraction was not different between GI-A and GI-B, whereas it was lower in GI than in GII (p<0.001). CONCLUSION: The data confirm that patients with left bundle branch block had decreased myocardial blood flow and coronary flow reserve and coronary flow reserve assessed by 82Rb-positron emission tomography imaging may be useful in identifying coronary artery disease in patients with left bundle branch block. (AU)

• Processo FAPESP: 10/51100-7 - Cintilografia de perfusão miocárdica com PET: bases clínicas para elaboração de gerador de estrôncio/rubídio-82 no Brasil
• Beneficiário: José Claudio Meneghetti
• Modalidade de apoio: Auxílio à Pesquisa - Regular