Key result
Preserved LV lateral wall work predicts a ~4-fold higher LVEF normalization rate after CRT.
Why the study?
LBBB may induce or aggravate heart failure, making it important to understand whether contractile asymmetry between septum and LV lateral wall drives heart failure and affects LV recovery with CRT.
Does the presence of LV lateral wall dysfunction affect the potential for recovery of LV function with CRT in patients with LBBB?
Cohort (n=64)
Does the presence of LV lateral wall dysfunction affect the potential for recovery of LV function with CRT in patients with LBBB?
Absolute Event Rate: 54% vs 13%
p-value: p=< 0.005
Preserved LV lateral wall work in patients with LBBB predicts a significantly higher likelihood of LVEF normalization following CRT, suggesting that the onset of lateral wall dysfunction may be an optimal time-point for intervention.
Preserved LV lateral wall work was associated with higher LVEF normalization after CRT; leaves open whether this marker should guide intervention timing in LBBB.
OBJECTIVES: This study sought to investigate if contractile asymmetry between septum and left ventricular (LV) lateral wall drives heart failure development in patients with left bundle branch block (LBBB) and whether the presence of lateral wall dysfunction affects potential for recovery of LV function with cardiac resynchronization therapy (CRT). BACKGROUND: LBBB may induce or aggravate heart failure. Understanding the underlying mechanisms is important to optimize timing of CRT. METHODS: ). Sixty-four patients underwent CRT and were re-examined after 6 months. RESULTS: however, LV lateral wall work was substantially reduced (p < 0.005). There was a moderate overall correlation between LV lateral wall work and LVEF (r = 0.58; p < 0.005). In CRT recipients, LVEF was normalized (≥50%) in 54% of patients with preserved LV lateral wall work, but only in 13% of patients with reduced LV lateral wall work (p < 0.005). CONCLUSIONS: In early stages, LBBB-induced heart failure is associated with impaired septal function but preserved lateral wall function. The advent of LV lateral wall dysfunction may be an optimal time-point for CRT.
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Sletten et al. (2021) conducted a cohort in Left bundle branch block and heart failure (n=64). Cardiac resynchronization therapy (CRT) vs. Reduced LV lateral wall work was evaluated on Normalization of LVEF (≥50%) (p=< 0.005). Cardiac resynchronization therapy normalized LVEF in 54% of patients with preserved LV lateral wall work compared to 13% of those with reduced LV lateral wall work (p < 0.005).
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