Left bundle branch block causes relative but not absolute septal underperfusion during exercise
| Autor: | Firat Duru, Oliver Gaemperli, Markus Bechir, Mehdi Namdar, Philipp A. Kaufmann, Tobias Hoefflinghaus, Michael Klainguti, Patrick T. Siegrist, Tiziano Schepis, Pascal Koepfli, Christophe A. Wyss |
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| Přispěvatelé: | University of Zurich |
| Rok vydání: | 2009 |
| Předmět: |
Male
Gauche effect Heart block Bundle-Branch Block 610 Medicine & health 030204 cardiovascular system & hematology 2705 Cardiology and Cardiovascular Medicine 03 medical and health sciences Myocardial perfusion imaging 0302 clinical medicine Coronary Circulation Heart Septum medicine Humans 030212 general & internal medicine Exercise Aged Bundle branch block medicine.diagnostic_test Left bundle branch block business.industry Cardiac Pacing Artificial 10181 Clinic for Nuclear Medicine Blood flow Middle Aged medicine.disease 10022 Division of Surgical Research 10076 Center for Integrative Human Physiology Case-Control Studies Positron-Emission Tomography Anesthesia Circulatory system 10209 Clinic for Cardiology 570 Life sciences biology Female Cardiomyopathies Cardiology and Cardiovascular Medicine business Perfusion |
| Zdroj: | European Heart Journal. 30:2993-2999 |
| ISSN: | 1522-9645 0195-668X |
| DOI: | 10.1093/eurheartj/ehp372 |
| Popis: | Aims Left bundle branch block (LBBB) often causes septal perfusion defects in radionuclide myocardial perfusion imaging using exercise (Ex) but rarely using vasodilator stress. We studied whether this is due to an underlying structural disease inherent to spontaneous LBBB or whether it is also found in temporary LBBB induced by right ventricular pacing (PM) indicating a functional rather than a structural alteration. Methods and results Regional myocardial blood flow (MBF) at rest and at Ex was measured with(15)O-H(2)O and PET in 10 age-matched healthy volunteers (controls), 10 LBBB patients and 10 PM patients with right ventricular pacing off and on (PM off and PM on). Although at Ex septal MBF tended to be higher in LBBB than in controls (3.04 +/- 1.18 vs. 2.27 +/- 0.72 mL/min/g; P= ns), the ratio septal/lateral MBF was 19% lower in LBBB than in controls (P < 0.05). Similarly, switching PM on at Ex decreased the ratio septal/lateral MBF by 17% (P < 0.005). Conclusion The apparent septal perfusion defect in LBBB is mainly due to a relative lateral hyperperfusion rather than to an absolute septal flow decrease. This pattern seems to be reversibly inducible by right ventricular pacing, suggesting a functional rather than a structural alteration |
| Databáze: | OpenAIRE |
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