{"title":"超声心动图与锝扫描对LBBB患者LVEF精确评价及比较的研究（SPECT-LBBB研究）。","authors":"Vijaya Kumar Varada, Bhanu Duggal, Shishir Soni","doi":"10.1111/echo.70308","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Left bundle branch block (LBBB) is an indication for cardiac resynchronization therapy (CRT) in patients with severe left ventricular (LV) systolic dysfunction. Accurate estimation of LV ejection fraction (LVEF) by echocardiography is often challenging in LBBB, leading to uncertainty regarding CRT eligibility. Alternative imaging modalities, such as contrast echocardiography (CE) and single-photon emission computed tomography (SPECT) may provide more reliable LVEF in these cases.</p><p><strong>Aim: </strong>This study aimed to compare LVEF estimation by unenhanced trans-thoracic echocardiography (UE-TTE), CE, and SPECT in patients with LBBB and significant discrepancy (≥5%) between prior UE-TTE reports.</p><p><strong>Methods: </strong>Sixty patients with LBBB referred for SPECT between May 2022 and May 2023 underwent LVEF assessment with UE-TTE, CE, and SPECT. Correlation and absolute differences in LVEF estimate across modalities were analyzed.</p><p><strong>Results: </strong>LVEF on CE correlated strongly with SPECT (r = 0.976, r<sup>2</sup> = 0.952) outperforming UE-TTE (r = 0.824, r<sup>2</sup> = 0.679). Among patients with LVEF ≤ 35% by UE-TTE, 13 of 34 had LVEF ≥ 40% on SPECT, compared to only one of 21 by CE. An absolute LVEF difference ≥10% was observed in 40% (SPECT vs. UE-TTE) and 0.5% (SPECT vs. CE).</p><p><strong>Conclusion: </strong>In patients with LBBB and discordant LVEF values on UE-TTE, secondary evaluation with CE or SPECT improves accuracy of LVEF assessment, potentially optimizing CRT eligibility and clinical decision making.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 10","pages":"e70308"},"PeriodicalIF":1.4000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Study of Precise Evaluation and Comparison of LVEF on Technetium Scan With Echocardiography in Patients With LBBB (SPECT-LBBB Study).\",\"authors\":\"Vijaya Kumar Varada, Bhanu Duggal, Shishir Soni\",\"doi\":\"10.1111/echo.70308\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Left bundle branch block (LBBB) is an indication for cardiac resynchronization therapy (CRT) in patients with severe left ventricular (LV) systolic dysfunction. Accurate estimation of LV ejection fraction (LVEF) by echocardiography is often challenging in LBBB, leading to uncertainty regarding CRT eligibility. Alternative imaging modalities, such as contrast echocardiography (CE) and single-photon emission computed tomography (SPECT) may provide more reliable LVEF in these cases.</p><p><strong>Aim: </strong>This study aimed to compare LVEF estimation by unenhanced trans-thoracic echocardiography (UE-TTE), CE, and SPECT in patients with LBBB and significant discrepancy (≥5%) between prior UE-TTE reports.</p><p><strong>Methods: </strong>Sixty patients with LBBB referred for SPECT between May 2022 and May 2023 underwent LVEF assessment with UE-TTE, CE, and SPECT. Correlation and absolute differences in LVEF estimate across modalities were analyzed.</p><p><strong>Results: </strong>LVEF on CE correlated strongly with SPECT (r = 0.976, r<sup>2</sup> = 0.952) outperforming UE-TTE (r = 0.824, r<sup>2</sup> = 0.679). Among patients with LVEF ≤ 35% by UE-TTE, 13 of 34 had LVEF ≥ 40% on SPECT, compared to only one of 21 by CE. An absolute LVEF difference ≥10% was observed in 40% (SPECT vs. UE-TTE) and 0.5% (SPECT vs. CE).</p><p><strong>Conclusion: </strong>In patients with LBBB and discordant LVEF values on UE-TTE, secondary evaluation with CE or SPECT improves accuracy of LVEF assessment, potentially optimizing CRT eligibility and clinical decision making.</p>\",\"PeriodicalId\":50558,\"journal\":{\"name\":\"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques\",\"volume\":\"42 10\",\"pages\":\"e70308\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/echo.70308\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/echo.70308","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
背景：左束支阻滞（LBBB）是严重左室（LV）收缩功能障碍患者心脏再同步化治疗（CRT）的指征。通过超声心动图准确估计左室射血分数（LVEF）在LBBB中经常具有挑战性，导致CRT资格的不确定性。在这些病例中，其他成像方式，如对比超声心动图（CE）和单光子发射计算机断层扫描（SPECT）可能提供更可靠的LVEF。目的：本研究旨在比较无增强经胸超声心动图（UE-TTE）、CE和SPECT对LBBB患者LVEF的估计，并与之前UE-TTE报告的显著差异（≥5%）进行比较。方法：在2022年5月至2023年5月期间，60例LBBB患者接受SPECT检查，并通过UE-TTE、CE和SPECT评估LVEF。分析了不同模式下LVEF估计的相关性和绝对差异。结果：CE上LVEF与SPECT相关性较强（r = 0.976, r2 = 0.952），优于UE-TTE （r = 0.824, r2 = 0.679）。在UE-TTE检查LVEF≤35%的患者中，34例SPECT检查中有13例LVEF≥40%，而21例CE检查中只有1例。40% （SPECT vs. UE-TTE）和0.5% （SPECT vs. CE）的绝对LVEF差异≥10%。结论：对于LBBB和UE-TTE中LVEF值不一致的患者，用CE或SPECT进行二次评估可以提高LVEF评估的准确性，可能优化CRT的资格和临床决策。
The Study of Precise Evaluation and Comparison of LVEF on Technetium Scan With Echocardiography in Patients With LBBB (SPECT-LBBB Study).
Background: Left bundle branch block (LBBB) is an indication for cardiac resynchronization therapy (CRT) in patients with severe left ventricular (LV) systolic dysfunction. Accurate estimation of LV ejection fraction (LVEF) by echocardiography is often challenging in LBBB, leading to uncertainty regarding CRT eligibility. Alternative imaging modalities, such as contrast echocardiography (CE) and single-photon emission computed tomography (SPECT) may provide more reliable LVEF in these cases.
Aim: This study aimed to compare LVEF estimation by unenhanced trans-thoracic echocardiography (UE-TTE), CE, and SPECT in patients with LBBB and significant discrepancy (≥5%) between prior UE-TTE reports.
Methods: Sixty patients with LBBB referred for SPECT between May 2022 and May 2023 underwent LVEF assessment with UE-TTE, CE, and SPECT. Correlation and absolute differences in LVEF estimate across modalities were analyzed.
Results: LVEF on CE correlated strongly with SPECT (r = 0.976, r2 = 0.952) outperforming UE-TTE (r = 0.824, r2 = 0.679). Among patients with LVEF ≤ 35% by UE-TTE, 13 of 34 had LVEF ≥ 40% on SPECT, compared to only one of 21 by CE. An absolute LVEF difference ≥10% was observed in 40% (SPECT vs. UE-TTE) and 0.5% (SPECT vs. CE).
Conclusion: In patients with LBBB and discordant LVEF values on UE-TTE, secondary evaluation with CE or SPECT improves accuracy of LVEF assessment, potentially optimizing CRT eligibility and clinical decision making.
期刊介绍：
Echocardiography: A Journal of Cardiovascular Ultrasound and Allied Techniques is the official publication of the International Society of Cardiovascular Ultrasound. Widely recognized for its comprehensive peer-reviewed articles, case studies, original research, and reviews by international authors. Echocardiography keeps its readership of echocardiographers, ultrasound specialists, and cardiologists well informed of the latest developments in the field.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
