Left bundle branch block in patients with idiopathic dilated cardiomyopathy was associated with significantly worse septal peak left ventricular longitudinal systolic strain compared to patients without LBBB.
Observational (n=101)
No
Does the presence of left bundle branch block worsen left ventricular mechanics in patients with idiopathic dilated cardiomyopathy?
In patients with idiopathic dilated cardiomyopathy, the presence of LBBB is associated with significantly worse left ventricular mechanics and greater mechanical dyssynchrony compared to those without LBBB.
Absolute Event Rate: -3.12% vs -5.51%
p-value: p=<0.01
Objectives: Left bundle branch block (LBBB) is commonly associated with heart failure. We evaluated the prevalence and impact of LBBB on left ventricular mechanics using 2D strain imaging in patients with idiopathic dilated cardiomyopathy (IDCM). Methods: We included 101 patients with IDCM with mean age 38 ± 18 years: 74% were males and 13.9% of them were in NYHA Class III-IV. LBBB was present in 26 (37%) of included patients. Myocardial mechanics including longitudinal, circumferential strain and rotation and LV synchronization were assessed using two-dimensional strain imaging. Results: LBBB group had higher LV volumes, and PAP compared with non LBBB. Peak LV longitudinal systolic strain (εsys) of the septum and global LV SRsys were significantly lower in LBBB compared to non LBBB group (P 0.01, 0.03). TTP-d was greater in LBBB in comparison to non LBBB group (274.5 ± 116 versus 209.4 ± 139, P 0.02). The electromechanical delay between septal segments was 35 ± 18 ms and between lateral wall segments: 48 ± 24 ms, between anterior wall segments: 21 ± 11 and between inferior wall segments: 41 ± 12. Consequently, LV mechanical dyssynchrony was more evident in IDCM patients with LBBB. QRS width was correlated inversely with LV longitudinal strain and strain rate and electromechanical delay (P 0.0001) in non LBBB group. In LBBB QRS width was not related to cardiac mechanics. Using univariate analysis and after a multiple covariate adjustment, the baseline LBBB was associated with a significantly increased LV dysfunction. Conclusion:After correcting for potential confounders, LBBB was found to be associated with more deterioration of LV mechanics and exaggerated LV dyssynchrony in patients with IDCM.
Emara et al. (Tue,) conducted a observational in Idiopathic Dilated Cardiomyopathy (IDCM) (n=101). Left Bundle Branch Block (LBBB) vs. Non-LBBB was evaluated on Peak LV longitudinal systolic strain (εsys) of the septum (p=<0.01). Left bundle branch block in patients with idiopathic dilated cardiomyopathy was associated with significantly worse septal peak left ventricular longitudinal systolic strain compared to patients without LBBB.