TY - JOUR
T1 - Impact of intraventricular conduction delay on coronary haemodynamics
T2 - A study with intracoronary Doppler in patients with bundle branch blocks and normal coronary arteries
AU - Wieneke, Heinrich
AU - Sattler, Katherine
AU - von Birgelen, Clemens
AU - Böse, Dirk
AU - Haude, Michael
AU - Rechenberg, Wolfram
AU - Sack, Stefan
AU - Dagres, Nikolaos
AU - Erbel, Raimund
PY - 2006/3/1
Y1 - 2006/3/1
N2 - 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.
AB - 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.
KW - Coronary flow
KW - Doppler
KW - Left bundle branch block
KW - Right bundle branch block
UR - http://www.scopus.com/inward/record.url?scp=33646832888&partnerID=8YFLogxK
U2 - 10.1093/europace/euj019
DO - 10.1093/europace/euj019
M3 - Article
C2 - 16627430
AN - SCOPUS:33646832888
SN - 1099-5129
VL - 8
SP - 151
EP - 156
JO - Europace
JF - Europace
IS - 3
ER -
