Gomez M V, Lorente Castro B C, Jané P, García-Zoghby L, Martínez-Lorca A, Pérez J A
Medicina Nuclear, Hospital Ramón y Cajal, Madrid, España.
Hospital Universitario Ramón y Cajal, Madrid, España.
Rev Esp Med Nucl Imagen Mol (Engl Ed). 2018 Sep-Oct;37(5):273-276. doi: 10.1016/j.remn.2018.02.005. Epub 2018 Apr 18.
Exercise-induced left bundle branch block (EI-LBBB) is a rare circumstance of unknown significance. The purpose of this paper is to describe the scintigraphic features and the prognostic value of this finding.
We reviewed the features of 1,885 patients who had visited our department to undergo GATED-SPECT ergometry to diagnose ischaemic heart disease. Seven patients showed EI-LBBB throughout the exercise testing. Coronary angiography was performed in 4 of them. Patients were followed-up over an average period of time of 30±8 months. The onset of major cardiovascular events was recorded during the follow-up period.
The prevalence of EI-LBBB was 0.37%. Six out of 7 patients were women. Myocardial function and perfusion were normal in 3 patients. Three patients had fixed perfusion defects and one patient had a reversible defect. Two out of the 4 patients showing perfusion defects presented a moderate-severe decrease of the left ventricular ejection fraction. None of the 4 patients with perfusion defects were found to have coronary disease on coronary angiography.
The prevalence of EI-LBBB among the patients that came to undergo GATED-SPECT ergometry was very low. The finding was more frequent in women. In our series, 2 patients presented non-ischaemic structural heart disease, but no patient was diagnosed with coronary artery disease. In our patients the presence of EI-LBBB did not relate to a greater risk of experiencing a major cardiovascular event.
运动诱发的左束支传导阻滞（EI-LBBB）是一种意义不明的罕见情况。本文旨在描述这一发现的闪烁造影特征及其预后价值。
我们回顾了1885例到我院接受门控单光子发射计算机断层扫描（GATED-SPECT）运动试验以诊断缺血性心脏病患者的特征。7例患者在整个运动试验过程中均表现为EI-LBBB。其中4例患者接受了冠状动脉造影。对患者进行了平均30±8个月的随访。记录随访期间主要心血管事件的发生情况。
EI-LBBB的患病率为0.37%。7例患者中有6例为女性。3例患者的心肌功能和灌注正常。3例患者有固定灌注缺损，1例患者有可逆性缺损。4例出现灌注缺损的患者中有2例左心室射血分数中度至重度降低。4例有灌注缺损的患者在冠状动脉造影中均未发现冠心病。
在接受GATED-SPECT运动试验的患者中，EI-LBBB的患病率非常低。这一发现多见于女性。在我们的系列研究中，2例患者患有非缺血性结构性心脏病，但没有患者被诊断为冠状动脉疾病。在我们的患者中，EI-LBBB的存在与发生主要心血管事件的较高风险无关。
