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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Cardiac resynchronization therapy can reverse abnormal myocardial strain distribution in patients with heart failure

Ole A Breithardt1, Christoph Stellbrink, Lieven Herbots

  • 1Department of Cardiology, University Hospital Aachen, Aachen, Germany. olebreithardt@gmx.de

Journal of the American College of Cardiology
|August 9, 2003
PubMed

Insights

Cardiac resynchronization therapy (CRT) can reverse abnormal myocardial strain patterns caused by left bundle branch block (LBBB). This study shows CRT normalizes septal-lateral strain differences, potentially improving patient selection for this heart failure treatment.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Dilated hearts with left bundle branch block (LBBB) exhibit abnormal myocardial strain distribution.
  • The impact of cardiac resynchronization therapy (CRT) on these abnormal strain patterns remains unclear.

Purpose of the Study:

  • To investigate the effects of CRT on regional myocardial strain distribution.
  • To assess changes in strain rate (SR) and strain using echocardiography before and after CRT in patients with LBBB.

Main Methods:

  • Studied 18 patients with symptomatic systolic heart failure and LBBB.
  • Utilized Doppler myocardial imaging to obtain longitudinal systolic velocity, SR, and strain data from septal and lateral walls.
  • Acquired data before and after CRT implementation.

Main Results:

  • Before CRT, the mid-lateral wall showed significantly higher peak SR and strain compared to the mid-septal wall.
  • CRT reversed this septal-lateral difference, normalizing strain distribution.
  • The septal-lateral difference in mid-segmental peak strain changed significantly after CRT.

Conclusions:

  • Left bundle branch block induces significant, abnormal redistribution of myocardial fiber strains.
  • CRT effectively reverses these abnormal septal-lateral strain relationships.
  • Identifying specific reversible strain patterns noninvasively may enhance patient selection for CRT.
Abstract

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