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20.10.2020 | ORIGINAL ARTICLE

Diagnostic accuracy of SPECT and PET myocardial perfusion imaging in patients with left bundle branch block or ventricular-paced rhythm

verfasst von: Mahesh K. Vidula, MD, Philip Wiener, DO, Senthil Selvaraj, MD, MA, Muhammad Shoaib Khan, MD, Usman Abdul Salam, MD, Chaitanya Rojulpote, MD, Scott D. Metzler, PhD, Srinivas Denduluri, PhD, Marie Guerraty, MD, PhD, Howard Julien, MD, Paco E. Bravo, MD

Erschienen in: Journal of Nuclear Cardiology | Ausgabe 3/2021

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Abstract

Background

The difference in diagnostic accuracy of coronary artery disease (CAD) between vasodilator SPECT and PET myocardial perfusion imaging (MPI) in patients with left bundle branch block (LBBB) or ventricular-paced rhythm (VPR) is unknown.

Methods

We identified patients with LBBB or VPR who underwent either vasodilator SPECT or PET MPI and subsequent coronary angiography. LBBB/VPR-related septal and anteroseptal defects were defined as perfusion defects involving those regions in the absence of obstructive CAD in the left anterior descending artery or left main coronary artery.

Results

Of the 55 patients who underwent coronary angiography, 38 (69%) underwent SPECT and 17 patients (31%) underwent PET. PET compared to SPECT demonstrated higher sensitivity (88% vs 60%), specificity (56% vs 14%), positive predictive value (64% vs 20%), negative predictive value (83% vs 50%), and overall superior diagnostic accuracy (AUC .72 (95% CI .50-.93) vs .37 (95% CI .20-.54), P = .01) to detect obstructive CAD. LBBB/VPR-related septal and anteroseptal defects were more common with SPECT compared to PET (septal: 72% vs 17%, P = .001; anteroseptal: 47% vs 8%, P = .02).

Conclusions

PET has higher diagnostic accuracy when compared to SPECT for the detection of obstructive CAD in patients with LBBB or VPR.

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Titel: Diagnostic accuracy of SPECT and PET myocardial perfusion imaging in patients with left bundle branch block or ventricular-paced rhythm
verfasst von: Mahesh K. Vidula, MD
Philip Wiener, DO
Senthil Selvaraj, MD, MA
Muhammad Shoaib Khan, MD
Usman Abdul Salam, MD
Chaitanya Rojulpote, MD
Scott D. Metzler, PhD
Srinivas Denduluri, PhD
Marie Guerraty, MD, PhD
Howard Julien, MD
Paco E. Bravo, MD
Publikationsdatum: 20.10.2020
Verlag: Springer International Publishing
Erschienen in: Journal of Nuclear Cardiology / Ausgabe 3/2021
Print ISSN: 1071-3581
Elektronische ISSN: 1532-6551
DOI: https://doi.org/10.1007/s12350-020-02398-5

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Diagnostic accuracy of SPECT and PET myocardial perfusion imaging in patients with left bundle branch block or ventricular-paced rhythm