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Left ventricular regional contraction abnormalities by echocardiographic speckle tracking in combined right bundle branch with left anterior fascicular block compared to left bundle branch block.

Publication ,  Journal Article
Leeters, IPM; Davis, A; Zusterzeel, R; Atwater, B; Risum, N; Søgaard, P; Klem, I; Nijveldt, R; Wagner, GS; Gorgels, APM; Kisslo, J
Published in: J Electrocardiol
2016

BACKGROUND: In contrast to LBBB patients less is known about patients with RBBB+LAFB regarding LV contractile abnormalities and the potential role of CRT. This study investigated whether patients with RBBB+LAFB morphology have echocardiographic mechanical strain abnormalities between the inferior and anterior LV walls, similar to abnormalities between septal and lateral walls in LBBB. METHODS AND RESULTS: Ten healthy volunteers with no-BBB, 28 LBBB and 28 RBBB+LAFB heart failure patients were included in this retrospective study. Two-dimensional regional-strains were obtained by speckle-tracking. Scar was assessed by CMR. Response on echo was defined as normal, classical, borderline or other pattern. The number of classical patterns in LBBB was significantly higher than in RBBB+LAFB and no-BBB groups (p<0.001 for both). Contrary, the RBBB+LAFB group showed a significantly higher number of borderline patterns compared to other groups (LBBB: p=0.042, no-block: p=0.012). In addition, RBBB+LAFB patients had more scar than LBBB patients (9.9% vs 3.4%, p=0.041), and the average amount of scar in each wall was also higher in RBBB+LAFB (<5% in LBBB and <16% in RBBB+LAFB). CONCLUSIONS: Patients with RBBB+LAFB on ECG and clinical HF demonstrate echocardiographic wall motion abnormalities between inferior and anterior LV walls, similar to abnormalities found between septal and lateral LV walls in patients with LBBB and HF. Fewer patients with RBBB+LAFB showed a classical pattern of opposing wall motion compared to LBBB. Factors that might alter strain patterns in RBBB+LAFB, including the detailed presence or absence of LV scar and coexisting block of the central fascicle, should be assessed in future studies.

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Published In

J Electrocardiol

DOI

EISSN

1532-8430

Publication Date

2016

Volume

49

Issue

3

Start / End Page

353 / 361

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Stroke Volume
  • Sensitivity and Specificity
  • Reproducibility of Results
  • Middle Aged
  • Male
  • Image Interpretation, Computer-Assisted
  • Humans
  • Female
  • Elasticity Imaging Techniques
 

Citation

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Chicago
ICMJE
MLA
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Leeters, I. P. M., Davis, A., Zusterzeel, R., Atwater, B., Risum, N., Søgaard, P., … Kisslo, J. (2016). Left ventricular regional contraction abnormalities by echocardiographic speckle tracking in combined right bundle branch with left anterior fascicular block compared to left bundle branch block. J Electrocardiol, 49(3), 353–361. https://doi.org/10.1016/j.jelectrocard.2016.02.002
Leeters, Irene P. M., Ashlee Davis, Robbert Zusterzeel, Brett Atwater, Niels Risum, Peter Søgaard, Igor Klem, et al. “Left ventricular regional contraction abnormalities by echocardiographic speckle tracking in combined right bundle branch with left anterior fascicular block compared to left bundle branch block.J Electrocardiol 49, no. 3 (2016): 353–61. https://doi.org/10.1016/j.jelectrocard.2016.02.002.
Leeters, Irene P. M., et al. “Left ventricular regional contraction abnormalities by echocardiographic speckle tracking in combined right bundle branch with left anterior fascicular block compared to left bundle branch block.J Electrocardiol, vol. 49, no. 3, 2016, pp. 353–61. Pubmed, doi:10.1016/j.jelectrocard.2016.02.002.
Leeters IPM, Davis A, Zusterzeel R, Atwater B, Risum N, Søgaard P, Klem I, Nijveldt R, Wagner GS, Gorgels APM, Kisslo J. Left ventricular regional contraction abnormalities by echocardiographic speckle tracking in combined right bundle branch with left anterior fascicular block compared to left bundle branch block. J Electrocardiol. 2016;49(3):353–361.
Journal cover image

Published In

J Electrocardiol

DOI

EISSN

1532-8430

Publication Date

2016

Volume

49

Issue

3

Start / End Page

353 / 361

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Stroke Volume
  • Sensitivity and Specificity
  • Reproducibility of Results
  • Middle Aged
  • Male
  • Image Interpretation, Computer-Assisted
  • Humans
  • Female
  • Elasticity Imaging Techniques