Document Detail


Defect images in stress thallium-201 myocardial scintigraphy in patients with complete left bundle branch block: comparison of exercise stress and pharmacological stress.
MedLine Citation:
PMID:  17460878     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Stress thallium-201 (201Tl) myocardial scintigraphy can demonstrate perfusion abnormalities, especially in the septum in patients with complete left bundle branch block (CLBBB) even with angiographically normal coronary arteries. Differences in the images between exercise and pharmacological stress 201Tl myocardial scintigraphy were evaluated in patients with CLBBB and normal coronary arteries. METHODS: Forty-five patients with CLBBB underwent exercise stress using treadmill or pharmacological (adenosine triphosphate) stress 201Tl myocardial scintigraphy from October 1997 to February 2003. Patients with myocardial diseases were excluded, such as cardiomyopathy and coronary artery diseases detected by echocardiography and/or cardiac catheterization. The myocardial segment was classified according to the American Heart Association style for coronary artery disease. RESULTS: Peak blood pressure levels and heart rates were significantly higher in the exercise stress group than in the pharmacological stress group (p < 0.001). The rate of defects in stress images was significantly higher in the exercise stress group (72.4%; 21/29 cases) than in the pharmacological stress group (18.8%; 3/16 cases) (p < 0.01). The rate of redistribution of observed defects in delayed images was 76.2% (16/21 cases) in the exercise stress group, and 0% (0/3 cases)in the pharmacological stress group (p < 0.01). The myocardial segments showing defects were different between the exercise stress group and the pharmacological stress group. CONCLUSIONS: Patients with CLBBB showed different frequencies of defects by stress 201Tl myocardial scintigraphy according to the stress method. Moreover, defects also occured in areas other than the septum. Blood pressure and heart rate were involved in the mechanisms of defects in left bundle branch block.
Authors:
Hideki Sasaki; Mitsuyuki Shimizu; Kazuhiko Ogawa; Fumiko Okazaki; Tsuneo Mizokami; Masafumi Kusaka; Yoshiki Uehara; Ikuo Taniguchi; Seibu Mochizuki
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of cardiology     Volume:  49     ISSN:  0914-5087     ISO Abbreviation:  J Cardiol     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-27     Completed Date:  2007-06-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804703     Medline TA:  J Cardiol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  179-85     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Nishi-shinbashi, Minato-ku, Tokyo. hsasaki@jikei.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adenosine Triphosphate / diagnostic use*
Aged
Blood Pressure
Bundle-Branch Block / physiopathology,  radionuclide imaging*
Coronary Angiography
Exercise Test*
Female
Heart / radionuclide imaging*
Humans
Male
Middle Aged
Thallium Radioisotopes / diagnostic use*
Tomography, Emission-Computed, Single-Photon
Chemical
Reg. No./Substance:
0/Thallium Radioisotopes; 56-65-5/Adenosine Triphosphate

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