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Updated: Aug 11, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
[Myocardial perfusion study in patients with right bundle branch block]
R L de Paula1, M C Giorgi, J Soares Júnior
1Instituto do Coração do Hospital das Clínicas, FMUSP.
Insights
Myocardial perfusion scintigraphy accurately detects coronary artery disease in patients with right bundle branch block (RBBB). The test maintains high sensitivity and specificity, proving reliable for diagnosing blockages.
Area of Science:
- Cardiology
- Nuclear Medicine
- Diagnostic Imaging
Background:
- Right bundle branch block (RBBB) can complicate the interpretation of electrocardiograms.
- Assessing coronary artery disease (CAD) in RBBB patients requires reliable non-invasive imaging techniques.
Purpose of the Study:
- To determine the diagnostic accuracy of myocardial perfusion scintigraphy (MPS) for detecting CAD.
- To evaluate the sensitivity and specificity of MPS in patients specifically diagnosed with RBBB.
Main Methods:
- Retrospective analysis of 31 patients with RBBB who underwent MPS (exercise or dipyridamole stress).
- Comparison of scintigraphic findings with cinecoronariography results.
- Segmentation of left ventricle images into territories corresponding to major coronary arteries.
Main Results:
- MPS demonstrated an overall sensitivity of 87% and specificity of 100% for detecting significant coronary artery lesions in RBBB patients.
- Sensitivity varied by coronary territory: 72% (LAD), 67% (RCA), 55% (Circumflex).
- Specificity remained high across all territories (100% for LAD and Circumflex, 94% for RCA).
Conclusions:
- Myocardial perfusion scintigraphy is a sensitive and specific tool for diagnosing coronary artery disease in patients with RBBB.
- The presence of RBBB does not significantly impair the diagnostic performance of MPS for CAD detection.
Purpose:
To evaluate the sensitivity and specificity of myocardial perfusion scintigraphy in the detection of coronary artery disease in patients with right bundle branch block (RBBB).
Methods:
Thirty one patients (24 male, 62.3 +/- 10.5 years) with RBBB, submitted to myocardial perfusion scintigraphy associated with exercise (n = 7) or dipyridamole (n = 24) and previous cinecoronariography were studied retrospectively. Left ventricle scintigraphic image was divided in three segments corresponding to the three main epicardic coronary territories in a total of 93 segments. Cineangiographic and scintigraphic data were then compared according to the different artery territories.
Results:
Twenty three patients had significant lesions (> or = 60%) in one or more coronary arteries and eight had no obstruction. Forty nine segments were irrigated by normal coronary arteries and 44 were related to arteries that had significant lesions. Twenty out of twenty three patients showed alterations in perfusion (sensitivity = 87%). All patients without coronary obstructions showed normal perfusion scintigraphy (specificity = 100%). One of the segments perfused by normal coronaries showed abnormal scintigraphy. Scintigraphy showed perfusion defects in 29 out of 44 segments with coronary obstructions. Sensitivity and specificity of the method for each arterial territory were 72% and 100% (left descending coronary artery), 67% and 94% (right coronary artery), 55% and 100% (circunflex coronary artery), respectively.
Conclusion:
The presence of RBBB does not modify the sensitivity and specificity of the method in the detection of coronary artery disease.
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