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Updated: Jun 17, 2026

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
08:13

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography

Published on: February 16, 2016

Myocardial perfusion SPECT identifies patients with left bundle branch block patterns at high risk for future

Tim J F ten Cate1, Johannes C Kelder, Herbert W M Plokker

  • 1Department of Nuclear Medicine, Sint Antonius Hospital, Nieuwegein, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands. timtencate@yahoo.com

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology
|December 25, 2009
PubMed

Insights

Myocardial perfusion SPECT (MPS) is valuable for patients with left bundle branch block (LBBB) or right ventricular apical (RVA) pacing. Patients with perfusion defects beyond abnormal activation related defects (AARD) have a worse cardiac prognosis.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Diagnostic Imaging

Background:

  • Myocardial perfusion SPECT (MPS) value is debated in patients with left bundle branch block (LBBB) or right ventricular apical (RVA) pacing.
  • Abnormal activation related defects (AARD) on MPS may not indicate poor prognosis.
  • Assessing prognostic value of MPS in LBBB or RVA pacing patients is crucial.

Purpose of the Study:

  • To evaluate the prognostic significance of myocardial perfusion SPECT (MPS) in patients with left bundle branch block (LBBB) or right ventricular apical (RVA) pacing.
  • To differentiate prognosis based on the extent of perfusion defects in these patients.

Main Methods:

  • Retrospective analysis of vasodilator stress MPS in patients with LBBB or RVA pacing (April 2002 - January 2006).
  • Group 1: Normal MPS or MPS with only AARD. Group 2: MPS with perfusion defects extending beyond AARD.
  • Primary outcomes: cardiac death, myocardial infarction, coronary revascularization.

Main Results:

  • Group 2 (96 patients) had significantly worse prognosis (49% survival) than Group 1 (101 patients, 91% survival).
  • Annual cardiac death rate was 6.4% in Group 2 vs. 0.7% in Group 1 (P < .001).
  • Prognosis did not differ between LBBB and RVA pacing patients.

Conclusions:

  • Patients with perfusion defects extending beyond AARD (Group 2) face significantly worse cardiac outcomes.
  • Low annual cardiac death rate (<1%) in Group 1 suggests a watchful waiting approach.
  • High cardiac death rate in Group 2 necessitates aggressive invasive strategies.
Abstract

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