Electromechanical coupling, uncoupling, and ventricular function in patients with bundle branch block: A tissue-doppler echocardiographic study
2004 (English)In: Echocardiography, ISSN 0742-2822, E-ISSN 1540-8175, Vol. 21, no 8, 687-698 p.Article in journal (Refereed) Published
Background: Left bundle branch block (LBBB) is associated with impaired left ventricular (LV) function and increased morbidity and mortality, especially in patients with structural heart diseases. The mechanisms are poorly understood. Subjects and Methods: Subjects with isolated LBBB (n = 20), right bundle branch block (RBBB, n = 20), and controls (C, n = 20) were studied with standard two-dimentional (2D), and color-encoded tissue-Doppler echocardiography (TDE). Inter- and intraventricular systolic and diastolic coordination were assessed from the TDE velocity profiles. LV function was assessed by 2D echocardiography, by TDE-derived peak systolic velocities, and the atrioventricular (AV) plane displacement. Results: Subjects with LBBB had longer electromechanical delays and longer isovolumic relaxation times than did the C and RBBB groups (P < 0.001). For the LBBB subjects compared with the RBBB and C groups, ejection times were shorter, peak systolic velocities and AV plane displacements were lower, they had larger LV end-systolic volumes and lower LV ejection fraction (all P < 0.001), and the atrial contribution to A-V plane displacement was higher (P < 0.01). There were no differences in diastolic or filling times among the groups. Conclusions: In patients with LBBB, delayed regional electromechanical coupling and uncoupling leads to generalized intra- and interventricular asynchrony, thereby explaining the depressed regional and global LV functions. Assessment of the electromechanical coupling and uncoupling processes and their consequences on cardiac function in patients with BBB and structural heart diseases may be possible using TDE.
Place, publisher, year, edition, pages
2004. Vol. 21, no 8, 687-698 p.
bundle branch block, tissue-Doppler echocardiography, left ventricular function, coronary-artery disease, intraventricular-conduction delay, chronic heart-failure, dilated cardiomyopathy, cardiac resynchronization, myocardial-infarction, abnormal activation, general-population, natural-history, mortality
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:kth:diva-23909DOI: 10.1111/j.0742-2822.2004.03164.xISI: 000225357700004PubMedID: 15546369OAI: oai:DiVA.org:kth-23909DiVA: diva2:342608
QC 20100525 QC 201202212010-08-102010-08-102012-03-23Bibliographically approved