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01-04-2013 | Original Article

Association between left ventricular mechanical dyssynchrony with myocardial perfusion and functional parameters in patients with left bundle branch block

Authors: Christopher Uebleis, MD, Xaver Hoyer, MD, Serge D. Van Kriekinge, PhD, Franziska Schuessler, Rüdiger Paul Laubender, MA, MPH, Alexander Becker, MD, Sebastian Lehner, MD, Andrei Todica, Alexander Haug, MD, Peter Bartenstein, MD, Paul Cumming, PhD, Guido Germano, PhD, Marcus Hacker, MD

Published in: Journal of Nuclear Cardiology | Issue 2/2013

Abstract

Objective

To identify predictors of left ventricular mechanical dyssynchrony (LVMD) in patients with known left bundle branch block (LBBB) using gated single-photon emission computed tomography (SPECT) phase analysis.

Methods

81 patients (74% male, 70 ± 10 years) with LBBB and suspected or known coronary artery disease underwent ECG-gated myocardial perfusion SPECT. LV perfusion and functional parameters were measured, and phase analysis was performed to quantify LV-dyssynchrony.

Results

35/81 patients (42%) had prior myocardial infarction (MI), and the mean left ventricular ejection fraction (LVEF) was 49% ± 16%. LVMD was present in 58/81 (72%) patients. The summed thickening score (STS) (P < .001; odds ratio 1.22) emerged as independent predictor for the presence of LVMD in a multivariate regression model. In addition, prior MI, low LVEF, summed stress score, summed rest score, summed motion score, and LAD rest extent were identified as predictors of LVMD in a univariate model. Clinical baseline characteristics, cardiac risk factors, and QRS duration (P = .051) had no influence on the presence of LVMD.

Conclusion

In patients with LBBB, the occurrence of LVMD as assessed by gated SPECT phase analysis is mainly influenced by reduced myocardial contractility as expressed by the STS. Proper discrimination between LVMD arising from known electrical conduction delay as opposed to areas of MI causing reduced regional contractility seems to be mandatory for therapy planning in patients with LVMD.

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Title: Association between left ventricular mechanical dyssynchrony with myocardial perfusion and functional parameters in patients with left bundle branch block
Authors: Christopher Uebleis, MD
Xaver Hoyer, MD
Serge D. Van Kriekinge, PhD
Franziska Schuessler
Rüdiger Paul Laubender, MA, MPH
Alexander Becker, MD
Sebastian Lehner, MD
Andrei Todica
Alexander Haug, MD
Peter Bartenstein, MD
Paul Cumming, PhD
Guido Germano, PhD
Marcus Hacker, MD
Publication date: 01-04-2013
Publisher: Springer US
Published in: Journal of Nuclear Cardiology / Issue 2/2013
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI: https://doi.org/10.1007/s12350-013-9673-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Association between left ventricular mechanical dyssynchrony with myocardial perfusion and functional parameters in patients with left bundle branch block

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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