UNLABELLED: Cardiac PET studies in patients with left bundle branch block (LBBB) are few, and the results are conflicting. In particular, even if a reduced uptake of FDG is reported, confirmation in a large group of patients and exact understanding of the underlying cause are lacking. METHODS: We selected 29 consecutive patients who had complete LBBB and no significant stenosis on coronary angiography scheduled for FDG and 13N-NH3 PET for myocardial viability evaluation at our center. Wall motion was evaluated using 2-dimensional echocardiography. Ten volunteers without coronary stenosis or LBBB served as a control group. RESULTS: All LBBB patients had a reverse mismatch in the septum, defined as reduced uptake of FDG in comparison with 13N-NH3. The mismatch extended to the anterior and inferior walls in 17 patients. The mean (+/-SD) septal-to-lateral ratio was 0.57 +/- 0.11 for FDG (range, 0.28-0.76) and 0.99 +/- 0.12 for 13N-NH3 (range, 0.75-1.18), with P < 0.0001. In contrast, no significant differences in uptake were seen in the control group, which had a septal-to-lateral ratio of 0.95 +/- 0.13 for FDG (range, 0.78-1.15; P < 0.01 with respect to LBBB patients) and 0.94 +/- 0.11 (range, 0.85-1.20) for 13N-NH3. CONCLUSION: Our study suggests that in LBBB patients without significant coronary stenosis, FDG uptake in the septum changes without a correlating change in perfusion. To avoid possible overestimation of necrosis, especially in the LAD territory, this phenomenon must be considered in evaluations of myocardial viability using FDG images.
UNLABELLED: Cardiac PET studies in patients with left bundle branch block (LBBB) are few, and the results are conflicting. In particular, even if a reduced uptake of FDG is reported, confirmation in a large group of patients and exact understanding of the underlying cause are lacking. METHODS: We selected 29 consecutive patients who had complete LBBB and no significant stenosis on coronary angiography scheduled for FDG and 13N-NH3 PET for myocardial viability evaluation at our center. Wall motion was evaluated using 2-dimensional echocardiography. Ten volunteers without coronary stenosis or LBBB served as a control group. RESULTS: All LBBB patients had a reverse mismatch in the septum, defined as reduced uptake of FDG in comparison with 13N-NH3. The mismatch extended to the anterior and inferior walls in 17 patients. The mean (+/-SD) septal-to-lateral ratio was 0.57 +/- 0.11 for FDG (range, 0.28-0.76) and 0.99 +/- 0.12 for 13N-NH3 (range, 0.75-1.18), with P < 0.0001. In contrast, no significant differences in uptake were seen in the control group, which had a septal-to-lateral ratio of 0.95 +/- 0.13 for FDG (range, 0.78-1.15; P < 0.01 with respect to LBBB patients) and 0.94 +/- 0.11 (range, 0.85-1.20) for 13N-NH3. CONCLUSION: Our study suggests that in LBBB patients without significant coronary stenosis, FDG uptake in the septum changes without a correlating change in perfusion. To avoid possible overestimation of necrosis, especially in the LAD territory, this phenomenon must be considered in evaluations of myocardial viability using FDG images.
Authors: David Birnie; Rob A de Kemp; Anthony S Tang; Terence D Ruddy; Michael H Gollob; Ann Guo; Kathryn Williams; Kerry Thomson; Jean N DaSilva; Rob S Beanlands Journal: J Nucl Cardiol Date: 2011-12-10 Impact factor: 5.952
Authors: C M C van Campen; Frans C Visser; Arno P van der Weerdt; Paul Knaapen; Emile F I Comans; Adriaan A Lammertsma; Carel C de Cock; Cees A Visser Journal: Eur J Nucl Med Mol Imaging Date: 2006-09-26 Impact factor: 9.236
Authors: Li Wei; Yong-Yi Lu; Yi-Min Hua; Kai-Yu Zhou; Qiang-Hua Ye; Chuan Wang; Xiao Wang; Song Yan; Ju-Fang Liu Journal: Zhongguo Dang Dai Er Ke Za Zhi Date: 2017-06
Authors: Daniel D Anselm; Anjali H Anselm; Jennifer Renaud; Harold L Atkins; Robert de Kemp; Ian G Burwash; Kathryn A Williams; Ann Guo; Cathy Kelly; Jean Dasilva; Rob S B Beanlands; Christopher A Glover Journal: J Nucl Cardiol Date: 2011-05-13 Impact factor: 5.952
Authors: Kevin A Bybee; Joseph Murphy; Abhiram Prasad; R Scott Wright; Amir Lerman; Charanjit S Rihal; Panithaya Chareonthaitawee Journal: J Nucl Cardiol Date: 2006 Mar-Apr Impact factor: 5.952