Author + information
- Paul Cremer,
- Richard Brunken,
- Venu Menon,
- Manuel Cerqueira and
- Wael Jaber
In patients with LBBB, pharmacologic stress testing is preferred for diagnosing coronary artery disease (CAD) as exercise causes a greater increase in heart rate (HR) and can lead to septal perfusion artifacts. However, the incidence of this artifact has not been well defined with Regadenoson. We assessed the relationship between heart rate and septal perfusion abnormalities in patients undergoing SPECT and PET MPI.
We retrospectively studied consecutive patients with LBBB from August 2012 through July 2014. From our database, we assessed septal perfusion abnormalities that may represent artifacts from a LBBB.
In a cohort of 440 patients (67 PET, 373 SPECT; 71 + 11 years), comorbidities were more common in patients undergoing PET compared to SPECT (CAD 60.6% v 40.0%, p = 0.003; ejection fraction 32 + 16% v 55 + 16%, p <0.001). Possible septal perfusion artifacts were less common in PET v SPECT (1.5% v 19.3%, p <0.001). When compared to SPECT, PET patients had increased resting HRs (76 + 14 v 69 + 12, p<0.001), but a blunted response to Regadenoson (peak 90 + 18 v 95 + 18, p = 0.04; change 14 + 11 v 26 + 14, p < 0.001). Among SPECT patients, septal perfusion abnormalities were more common with increased HRs (rest 71 + 14 v 68 + 12, p = 0.06; peak 101 + 17 v 93 + 18, p = 0.001; change 30 + 15 v 25 + 14, p = 0.01)(Figure).
In patients with LBBB, septal perfusion abnormalities with SPECT are common and associated with increased HRs. These abnormalities were rare with PET.
Poster Hall B1
Saturday, March 14, 2015, 3:45 p.m.-4:30 p.m.
Session Title: Cardiac PET Imaging
Abstract Category: 19. Non Invasive Imaging: Nuclear
Presentation Number: 1135-013
- 2015 American College of Cardiology Foundation