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Global and regional myocardial oxygen consumption and blood flow in severe cardiomyopathy with left bundle branch block
Author(s) -
Lindner Oliver,
Vogt Jürgen,
Baller Detlev,
Kammeier Annett,
Wielepp Peter,
Holzinger Jens,
Lamp Barbara,
Horstkotte Dieter,
Burchert Wolfgang
Publication year - 2005
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2004.07.003
Subject(s) - left bundle branch block , cardiology , ejection fraction , cardiac resynchronization therapy , medicine , blood flow , cardiomyopathy , dilated cardiomyopathy , heart failure , bundle branch block , ischemic cardiomyopathy , electrocardiography
Objective: In patients with dilated cardiomyopathy (DCM), left bundle branch block (LBBB) is a common finding. The characteristic feature is an asynchronous septal wall motion and most frequently a delay of the lateral and/or posterior wall segments. With the onset of cardiac resynchronization therapy, there is a focus on the specific pathophysiology of a LBBB. However, quantitative data on regional myocardial oxygen consumption (MVO 2 ) and blood flow (MBF) are missing. Methods: We studied 31 patients with severe DCM and LBBB (ejection fraction 22.1±7.1%) and 14 patients with mild to moderate DCM without LBBB (ejection fraction 46.7±7.9%). Global and regional MVO 2 as well as MBF were determined from a dynamic 11 C‐acetate positron emission tomography (PET) study. Results: Global MVO 2 and MBF were lower in the DCM group with LBBB than in the control group ( P <0.05). Regionally, the LBBB group revealed a higher ( P <0.05) MVO 2 and MBF in the lateral wall than in the other walls. The control group did not show significant differences between the myocardial walls and demonstrated a smaller variability of the parameters. Conclusion: DCM patients with LBBB exhibit a more heterogeneous distribution of MVO 2 and MBF among the myocardial walls than DCM patients without LBBB. Due to the LBBB associated electromechanical alterations, the highest regional values of MVO 2 and MBF are found in the lateral wall.