Document Detail


Predictors of coronary artery disease in patients with left bundle branch block who undergo myocardial perfusion imaging.
MedLine Citation:
PMID:  19653174     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Due to difficulties in diagnosing coronary ischemia in patients with left bundle branch block (LBBB), identifying clinical characteristics that might help to predict coronary artery disease (CAD) is important. Our study aimed to identify clinical predictors of CAD among patients with and without LBBB who undergo myocardial perfusion imaging (MPI). METHODS: All patients with LBBB who underwent MPI (LBBB group) from June 2005 to February 2007 were compared with patients with normal baseline electrocardiography who underwent treadmill MPI (non-LBBB group) during the same period. RESULTS: LBBB patients with CAD were younger and had lower ejection fraction (EF) compared to LBBB patients without CAD. Similarly non-LBBB patients with CAD had lower EF, but did not differ significantly in age compared to non-LBBB patients without CAD. Regression analysis among patients with LBBB showed that EF < 55% was the most significant predictor of CAD, after controlling for other factors. A regression analysis in non-LBBB patients showed that male gender and EF pound 55% were significant predictors of CAD. A regression analysis conducted in the combined data of both LBBB and non-LBBB groups showed male gender, EF pound 55% and LBBB to be the most significant predictors of CAD. CONCLUSIONS: Patients with LBBB have a high probability of CAD based on MPI findings. Patients with LBBB and reduced EF have a much higher likelihood of CAD compared to patients without LBBB and normal EF. Further studies on early invasive approach in patients with LBBB and reduced EF seem warranted.
Authors:
Vinodh Jeevanantham; Kavitha Manne; Mohan Sengodan; James M Haley; David H Hsi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiology journal     Volume:  16     ISSN:  1897-5593     ISO Abbreviation:  -     Publication Date:  2009  
Date Detail:
Created Date:  2009-08-04     Completed Date:  2009-10-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101392712     Medline TA:  Cardiol J     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  321-6     Citation Subset:  IM    
Affiliation:
Wake Forest University, Winston-Salem, NC 27157, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Bundle-Branch Block / epidemiology*,  radionuclide imaging*
Coronary Artery Disease / epidemiology*,  radionuclide imaging*
Diabetes Mellitus / epidemiology
Electrocardiography
Exercise Test*
Female
Humans
Hyperlipidemias / epidemiology
Hypertension / epidemiology
Logistic Models
Male
Middle Aged
Multivariate Analysis
Peripheral Vascular Diseases / epidemiology
Predictive Value of Tests
Prevalence
Retrospective Studies
Risk Factors
Smoking / epidemiology
Stroke Volume
Thallium Radioisotopes / diagnostic use
Chemical
Reg. No./Substance:
0/Thallium Radioisotopes

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