Document Detail


Impact of intraventricular conduction delay on coronary haemodynamics: a study with intracoronary Doppler in patients with bundle branch blocks and normal coronary arteries.
MedLine Citation:
PMID:  16627430     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Heinrich Wieneke; Katherine Sattler; Clemens von Birgelen; Dirk Böse; Michael Haude; Wolfram Rechenberg; Stefan Sack; Nikolaos Dagres; Raimund Erbel
Publication Detail:
Type:  Journal Article     Date:  2006-01-05
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  8     ISSN:  1099-5129     ISO Abbreviation:  Europace     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-04-21     Completed Date:  2006-05-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  151-6     Citation Subset:  IM    
Affiliation:
Department of Cardiology, University Duisburg-EssenHufelandstr. 55, D-45122 Essen Germany. heinrich.wieneke@uni-esen.de
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MeSH Terms
Descriptor/Qualifier:
Adenosine / pharmacology
Blood Flow Velocity
Bundle-Branch Block / metabolism,  physiopathology*,  ultrasonography
Coronary Circulation*
Coronary Vessels / ultrasonography
Electrocardiography
Female
Heart Conduction System / physiopathology*
Humans
Hyperemia
Male
Middle Aged
Myocardium / metabolism
Oxygen / metabolism
Ultrasonography, Interventional*
Vasodilator Agents / pharmacology
Ventricular Function, Left
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 58-61-7/Adenosine; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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