Comparison of myocardial contrast echocardiography with SPECT in the evaluation of coronary artery disease in asymptomatic patients with LBBB

Karavidas, Apostolos; Matsakas, Evangelos; Lazaros, George; Brestas, Paris; Avramidis, Dimitrios A.; Fotiadis, Ioannis; Korres, Dimitrios; Zacharoulis, Achilleas

doi:10.1016/j.ijcard.2005.10.004

Cited by 15 publications

(10 citation statements)

References 28 publications

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“…[3][4][5][6][7] This also was shown in a smaller study comparing MCE and SPECT. 23 No difference in sensitivity between the 2 techniques was noted for the detection of CAD. However, because reversible defects (suggesting myocardial ischemia) occurred in only 57% of CAD patients, a significant proportion of patients undergoing SPECT would inadvertently be denied revascularization.…”

Section: Discussionmentioning

confidence: 95%

“…However, in a smaller study of asymptomatic LBBB patients who demonstrated predominantly normal LV function, the performance of MCE and SPECT for the detection of CAD was similar to our study. 23 The control group in our study was small, and multiple comparisons were performed, which may have led to a false-positive result. To minimize the possibility of type I error rate, we performed a 1-way ANOVA with post hoc adjustment for multiple comparisons with the Tukey method.…”

Section: Study Limitationsmentioning

confidence: 93%

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Effects of Left Bundle-Branch Block on Cardiac Structure, Function, Perfusion, and Perfusion Reserve

et al. 2008

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Background-We aimed to investigate the cardiac effects of left bundle-branch block (LBBB) using myocardial contrast echocardiography (MCE) to ascertain the value of MCE for detecting coronary artery disease (CAD) and to uncover the mechanism that affects the accuracy of single-photon emission computed tomography (SPECT) in these patients. Methods and Results-Sixty-three symptomatic LBBB patients (group A), 10 left ventricular ejection fraction-matched control subjects without LBBB and no CAD (group B), and 10 normal control subjects (group C) underwent resting echocardiography. Rest and vasodilator MCE and SPECT were undertaken in LBBB patients. Septal (SW) and posterior wall (PW) thickness, thickening, quantitative myocardial blood flow (MBF), and MBF reserve were measured. SW/PW thickness and percentage thickening ratios were lower (PϽ0.01 and PϽ0.05, respectively) in group A compared with both groups B and C, but resting SW/PW MBF and MBF reserve ratios were similar in all 3 groups. MBF reserve but not MBF was reduced in groups A and B (2.2Ϯ0.7 versus 2.2Ϯ0.2; Pϭ0.98) compared with group C (3.1Ϯ0.5; PϽ0.01). SW thickness was an independent predictor (Pϭ0.006) of SPECT perfusion defects in LBBB patients without CAD. MCE (92%) had a sensitivity similar to SPECT (92%); however, the specificity of MCE (95%) was superior (PϽ0.0001) to SPECT (47%) for the detection of CAD. Conclusions-Despite asymmetrical reduction in SW thickness and function, MBF is preserved and MBF reserve is homogeneously reduced in LBBB patients with left ventricular systolic dysfunction. Because of partial volume effects, the accuracy of SPECT for detecting CAD was significantly compromised compared with MCE in this patient cohort.

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Section: Discussionmentioning

confidence: 95%

Section: Study Limitationsmentioning

confidence: 93%

Effects of Left Bundle-Branch Block on Cardiac Structure, Function, Perfusion, and Perfusion Reserve

et al. 2008

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“…Dobutamine stress echocardiography is a highly specific test (10,12), but sensitivity is moderate for septal ischemia in case of abnormal rest septal thickening (12). However, myocardial contrast echocardiography with adenosine seems to improve diagnostic accuracy (31). Finally, most studies excluded patients with a history of myocardial infarction or ventricular tachyarrhythmia or structural valve disease (10,12).…”

Section: Discussionmentioning

confidence: 99%

Non-Invasive Detection of Coronary Artery Disease in Patients With Left Bundle Branch Block Using 64-Slice Computed Tomography

Ghostine

Caussin

Daoud

et al. 2006

Journal of the American College of Cardiology

110

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“…Given that the development of perfusion defects are earlier than wall motion abnormalities in the ischaemic cascade, in theory the assessment of perfusion might increase the diagnostic accuracy of stress echocardiography. Karavidas et al compared adenosine stress echocardiography against SPECT and ICA [44]. This study was prospective, with 47 patients suspected of having CAD undergoing SPECT, then MCE 1-3 days later before having ICA within 1 week.…”

Section: Stress Echocardiographymentioning

confidence: 99%

Non-invasive assessment of coronary artery disease in patients with left bundle branch block

Mordi

Tzemos

2015

International Journal of Cardiology

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Comparison of myocardial contrast echocardiography with SPECT in the evaluation of coronary artery disease in asymptomatic patients with LBBB

Cited by 15 publications

References 28 publications

Effects of Left Bundle-Branch Block on Cardiac Structure, Function, Perfusion, and Perfusion Reserve

Effects of Left Bundle-Branch Block on Cardiac Structure, Function, Perfusion, and Perfusion Reserve

Non-Invasive Detection of Coronary Artery Disease in Patients With Left Bundle Branch Block Using 64-Slice Computed Tomography

Non-invasive assessment of coronary artery disease in patients with left bundle branch block

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