Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 1071-1076 |
| Journal | Journal of Electrocardiology |
| Volume | 51 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 2018 |
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Ejection fraction in left bundle branch block is disproportionately reduced in relation to amount of myocardial scar. / Axelsson, Jimmy; Wieslander, Björn; Jablonowski, Robert; Klem, Igor; Nijveldt, Robin; Schelbert, Erik B.; Sörensson, Peder; Sigfridsson, Andreas; Chaudhry, Uzma; Platonov, Pyotr G.; Borgquist, Rasmus; Engblom, Henrik; Strauss, David G.; Arheden, H. kan; Atwater, Brett D.; Ugander, Martin.
In: Journal of Electrocardiology, Vol. 51, No. 6, 2018, p. 1071-1076.Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - Ejection fraction in left bundle branch block is disproportionately reduced in relation to amount of myocardial scar
AU - Axelsson, Jimmy
AU - Wieslander, Björn
AU - Jablonowski, Robert
AU - Klem, Igor
AU - Nijveldt, Robin
AU - Schelbert, Erik B.
AU - Sörensson, Peder
AU - Sigfridsson, Andreas
AU - Chaudhry, Uzma
AU - Platonov, Pyotr G.
AU - Borgquist, Rasmus
AU - Engblom, Henrik
AU - Strauss, David G.
AU - Arheden, H. kan
AU - Atwater, Brett D.
AU - Ugander, Martin
PY - 2018
Y1 - 2018
N2 - Introduction: The relationship between left ventricular (LV) ejection fraction (EF) and LV myocardial scar can identify potentially reversible causes of LV dysfunction. Left bundle branch block (LBBB) alters the electrical and mechanical activation of the LV. We hypothesized that the relationship between LVEF and scar extent is different in LBBB compared to controls. Methods: We compared the relationship between LVEF and scar burden between patients with LBBB and scar (n = 83), and patients with chronic ischemic heart disease and scar but no electrocardiographic conduction abnormality (controls, n = 90), who had undergone cardiovascular magnetic resonance (CMR) imaging at one of three centers. LVEF (%) was measured in CMR cine images. Scar burden was quantified by CMR late gadolinium enhancement (LGE) and expressed as % of LV mass (%LVM). Maximum possible LVEF (LVEFmax) was defined as the function describing the hypotenuse in the LVEF versus myocardial scar extent scatter plot. Dysfunction index was defined as LVEFmax derived from the control cohort minus the measured LVEF. Results: Compared to controls with scar, LBBB with scar had a lower LVEF (median [interquartile range] 27 [19–38] vs 36 [25–50] %, p < 0.001), smaller scar (4 [1–9] vs 11 [6–20] %LVM, p < 0.001), and greater dysfunction index (39 [30–52] vs 21 [12–35] % points, p < 0.001). Conclusions: Among LBBB patients referred for CMR, LVEF is disproportionately reduced in relation to the amount of scar. Dyssynchrony in LBBB may thus impair compensation for loss of contractile myocardium.
AB - Introduction: The relationship between left ventricular (LV) ejection fraction (EF) and LV myocardial scar can identify potentially reversible causes of LV dysfunction. Left bundle branch block (LBBB) alters the electrical and mechanical activation of the LV. We hypothesized that the relationship between LVEF and scar extent is different in LBBB compared to controls. Methods: We compared the relationship between LVEF and scar burden between patients with LBBB and scar (n = 83), and patients with chronic ischemic heart disease and scar but no electrocardiographic conduction abnormality (controls, n = 90), who had undergone cardiovascular magnetic resonance (CMR) imaging at one of three centers. LVEF (%) was measured in CMR cine images. Scar burden was quantified by CMR late gadolinium enhancement (LGE) and expressed as % of LV mass (%LVM). Maximum possible LVEF (LVEFmax) was defined as the function describing the hypotenuse in the LVEF versus myocardial scar extent scatter plot. Dysfunction index was defined as LVEFmax derived from the control cohort minus the measured LVEF. Results: Compared to controls with scar, LBBB with scar had a lower LVEF (median [interquartile range] 27 [19–38] vs 36 [25–50] %, p < 0.001), smaller scar (4 [1–9] vs 11 [6–20] %LVM, p < 0.001), and greater dysfunction index (39 [30–52] vs 21 [12–35] % points, p < 0.001). Conclusions: Among LBBB patients referred for CMR, LVEF is disproportionately reduced in relation to the amount of scar. Dyssynchrony in LBBB may thus impair compensation for loss of contractile myocardium.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85053801386&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30497733
U2 - 10.1016/j.jelectrocard.2018.09.009
DO - 10.1016/j.jelectrocard.2018.09.009
M3 - Article
VL - 51
SP - 1071
EP - 1076
JO - Journal of Electrocardiology
JF - Journal of Electrocardiology
SN - 0022-0736
IS - 6
ER -