1 research outputs found
Predictors of coronary artery disease in patients with left bundle branch block who undergo myocardial perfusion imaging
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 £ 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 £ 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