Correlation between interventricular septal motion and left ventricular systolic-diastolic function in patients with...

The echocardiographic correlation between abnormal interventricular septal motion including systolic paradoxical, flat motion and early diastolic notch and ejection fraction, mean ventricular circumferential fiber shortening and early diastolic mitral filling velocity was studied in 46 patients with complete left bundle branch block. Systolic normal interventricular septal motion was used as the control. Ejection fraction was significantly smaller in the paradoxical(0.44 +/- 0.13, p < 0.02) and flat motion groups(0.38 +/- 0.09, p < 0.001) than in the normal group(0.54 +/- 0.1). Mean ventricular circumferential fiber shortening was significantly smaller in the flat motion group than in the normal group(0.72 +/- 0.19 vs 0.99 +/- 0.23 circ/sec, p < 0.002). The size of the notch was significantly smaller in the flat motion group than in the normal group (2.3 +/- 0.2 vs 4.8 +/- 0.8 mm, p < 0.0001). The deceleration rate of the notch was significantly slower in the paradoxical and flat motion groups than in the normal group(37.3 +/- 12.2, 31.3 +/- 8.1 vs 69.1 +/- 2.5 cm/sec, p < 0.0001). Early diastolic mitral filling velocity was slower in the flat motion group than in the other 2 groups. In conclusion, systolic flat interventricular septal motion showed more severe disturbances of left ventricular systolic and diastolic function than paradoxical interventricular septal motion in patients with complete left bundle branch block.