What does this research mean for the field?

Non-ischaemic regional wall motion abnormalities and reduced myocardial wall thickness can cause false positive results in resting SPECT myocardial perfusion imaging for the detection of myocardial infarction. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To determine whether non-ischemic left ventricular wall motion abnormalities and reduced myocardial wall thickness cause false-positive SPECT perfusion results for myocardial infarction.

September 15, 2026European Heart JournalOpen Access

Left ventricular wall motion abnormalities as well as reduced wall thickness can cause false positive results of routine SPECT perfusion imaging for detection of myocardial infarction

Q: What are the key findings of this study?

Dyskinetic segments caused significantly more false positive SPECT results for myocardial infarction compared to segments with normal wall motion (93% vs 5%, P<0.01).

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Left bundle branch block without coronary artery disease (n=19). Intervention: Wall motion abnormalities and reduced wall thickness vs. Normal wall motion and thickness. Primary outcome: False positive SPECT results for myocardial infarction (p=<0.01).

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Key result

Dyskinetic segments yield a ~93% false positive SPECT rate for MI versus normal wall motion.

P<0.01
n=19

Why the study?

Do wall motion abnormalities and reduced wall thickness cause false positive SPECT results for myocardial infarction in patients with LBBB?

Key Points

To determine whether non-ischemic left ventricular wall motion abnormalities and reduced myocardial wall thickness cause false-positive SPECT perfusion results for myocardial infarction.
Screened 139 patients presenting with left bundle branch block (LBBB) who had resting fixed SPECT defects, using coronary angiography to rule out coronary artery disease (CAD).
Enrolled 19 CAD-free patients (N=19) to undergo cardiovascular magnetic resonance (CMR) as the reference standard to correlate SPECT findings with wall thickness and motion across a 72-segment model.
CMR verified that 0% of the fixed SPECT defects represented true myocardial infarcts in all 19 patients, exactly matching areas of wall motion and thickness impairment instead.
False-positive SPECT infarct rates rose significantly with worsening wall motion, occurring in 5% of normal segments compared to 93% of dyskinetic segments (P<0.01).
Fixed defects appeared in 58% of segments with wall thickness 1 SD below mean and 93% of segments 2 SD below mean, compared to only 0.5% of segments with thickness above the mean (P<0.01).

Study Design

Type

Cross-Sectional (n=19)

Blinding

Blinded outcome assessment

Structured PICO

Do wall motion abnormalities and reduced wall thickness cause false positive SPECT results for myocardial infarction in patients with LBBB?

Population

19 patients with left bundle branch block and no coronary artery disease who underwent SPECT and CMR imaging.

Exposure

Resting single-photon emission computed tomography (SPECT) myocardial perfusion imaging

Comparator

Cardiovascular magnetic resonance (CMR) as the gold standard

Outcome

False positive detection of myocardial infarction by SPECT in relation to wall motion abnormalities and reduced wall thicknesssurrogate

Main Result

Absolute Event Rate: 93% vs 5%

p-value: p=<0.01

Wall motion abnormalities and reduced wall thickness in LBBB can cause false positive resting SPECT results for myocardial infarction in the absence of CAD.

Discussion

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Implication

Non-ischaemic wall motion abnormalities or thinning may yield false-positive SPECT infarcts; leaves open need for confirmatory CMR before changing diagnostic thresholds.

Cite This Study

Mahrholdt et al. (2005) conducted a cross-sectional in Left bundle branch block without coronary artery disease (n=19). Wall motion abnormalities and reduced wall thickness vs. Normal wall motion and thickness was evaluated on False positive SPECT results for myocardial infarction (p=<0.01). Dyskinetic segments caused significantly more false positive SPECT results for myocardial infarction compared to segments with normal wall motion (93% vs 5%, P<0.01).

synapsesocial.com/papers/6aa9b59583705aff8b6d8ecb https://doi.org/10.1093/eurheartj/ehi387

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Implication

Non-ischaemic wall motion abnormalities or thinning may yield false-positive SPECT infarcts; leaves open need for confirmatory CMR before changing diagnostic thresholds.

Left ventricular wall motion abnormalities as well as reduced wall thickness can cause false positive results of routine SPECT perfusion imaging for detection of myocardial infarction

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Left ventricular wall motion abnormalities as well as reduced wall thickness can cause false positive results of routine SPECT perfusion imaging for detection of myocardial infarction

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

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