Utility of Stress Echocardiography in Identifying Significant Coronary Artery Disease in Patients With Left Bundle-Branch Block

Abstract

Stress echocardiography has a poor positive predictive value to identify significant angiographic CAD in higher-risk patients with LBBB; however, the negative predictive value for hard ischemic events is similar to patients without LBBB.

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

“…Some more recent studies have improved this slightly, perhaps suggesting that more familiarity with the techniques has improved diagnostic accuracy, however, the fact that echocardiography mainly relies on wall motion analysis means that its accuracy, especially in diagnosis of LAD disease is reduced. In a retrospective review of 60 patients who underwent stress echocardiography, Lewis et al found that the technique had a poor specificity (64%) despite a sensitivity of 100% [35]. Positive predictive value was poor at around 40% for patients with or without prior MI.…”