Impact of intraventricular conduction delay on coronary haemodynamics: A study with intracoronary Doppler in patients with bundle branch blocks and normal coronary arteries

Heinrich Wieneke* (Corresponding Author), Katherine Sattler, Clemens von Birgelen, Dirk Böse, Michael Haude, Wolfram Rechenberg, Stefan Sack, Nikolaos Dagres, Raimund Erbel

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    6 Citations (Scopus)

    Abstract

    Aims: The impact of right bundle branch block (RBBB) and left bundle branch block (LBBB) on myocardial perfusion is not completely understood as data are often blurred by underlying cardiac disease. The present study investigates whether conduction delays per se affect coronary perfusion-an indirect measure of myocardial oxygen demand. Methods and results: Intracoronary Doppler and ultrasound were performed in 8 patients with RBBB, 10 patients with LBBB, and 10 control subjects. All patients had angiographically normal coronary arteries and normal left ventricular function. Baseline (bAPV) and adenosine-induced hyperaemic average flow velocity and coronary flow velocity reserve (CFVR) were measured in left anterior descending arteries. Intravascular ultrasound showed no difference in lumen cross-sectional area and plaque burden between groups. Patients with RBBB and LBBB had higher bAPV values than controls (19.0 ± 4.9, 21.9 ± 5.1, and 14.6 ± 2.4 cm/s, respectively; ANOVA P = 0.003). There was no difference between patients with LBBB and RBBB compared with controls in CFVR (2.8 ± 0.5, 3.0 ± 1.0, and 3.4 ± 0.7, respectively; ANOVA P = 0.21). Conclusion: Bundle branch blocks, in particular LBBB, are associated with an increased coronary flow velocity, which indicates enhanced myocardial oxygen demand on the basis of mechanoenergetic disturbance. This may contribute to the unfavourable outcome of patients with intraventricular conduction delay.

    Original languageEnglish
    Pages (from-to)151-156
    Number of pages6
    JournalEuropace
    Volume8
    Issue number3
    DOIs
    Publication statusPublished - 1 Mar 2006

    Keywords

    • Coronary flow
    • Doppler
    • Left bundle branch block
    • Right bundle branch block

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