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Differences in ventricular septal motion between subgroups of patients with heart failure

S G Horne1, R N Anderson, I Burwash

  • 1Department of Medicine, Dalhousie University, Halifax, Nova Scotia. ghorne@is.dal.ca

The Canadian Journal of Cardiology
|February 24, 2001
PubMed

Insights

In heart failure, the septum enhances left ventricular (LV) systolic function in normal conduction but this is lost in left bundle branch block (LBBB). This study explores septal contribution to LV function in heart failure patients.

Area of Science:

  • Cardiology
  • Cardiac Physiology
  • Echocardiography

Background:

  • Septal systolic motion is load-dependent, influenced by the end-diastolic trans-septal pressure gradient.
  • Understanding septal contribution is crucial for evaluating overall left ventricular (LV) systolic function.

Purpose of the Study:

  • To investigate the role of the septum in left ventricular (LV) systolic function in patients experiencing heart failure.
  • To compare septal function in heart failure patients with normal conduction versus those with left bundle branch block (LBBB).

Main Methods:

  • Echocardiograms from 12 normal subjects and 69 heart failure patients (normal conduction or LBBB) were analyzed.
  • Parasternal short axis LV areas were traced, and radial chords were used to calculate percentage shortening.
  • Septal and freewall chord shortening were compared to assess regional systolic function.

Main Results:

  • Patients with heart failure and normal conduction showed greater septal shortening compared to freewall shortening.
  • Heart failure patients with left bundle branch block (LBBB) exhibited paradoxical septal motion.
  • Area ejection fraction was significantly lower in heart failure patients with LBBB compared to those with normal conduction.

Conclusions:

  • Septal contribution to LV systolic function is enhanced in heart failure patients with normal conduction.
  • This enhanced septal function is diminished in heart failure with left bundle branch block (LBBB), leading to reduced area ejection fraction.
  • Further research into strategies for optimizing septal function in heart failure is warranted.
Abstract

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