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

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Association of left bundle branch block with left ventricular structure and function in hypertensive patients with

Z B Li1, K Wachtell, P M Okin

  • 1Department of Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA.

Journal of Human Hypertension
|April 9, 2004
PubMed

Insights

Electrocardiographic left bundle branch block (LBBB) in hypertensive patients with left ventricular hypertrophy (LVH) indicates worse cardiac function, even without increased LVH severity. This finding highlights LBBB as a marker for impaired systolic and diastolic function.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Cardiac Electrophysiology

Background:

  • Electrocardiographic (ECG) left bundle branch block (LBBB) is linked to left ventricular hypertrophy (LVH).
  • The relationship between LBBB and left ventricular (LV) geometry/function in hypertensive patients with ECG LVH remains unclear.

Purpose of the Study:

  • To investigate the association between LBBB and LV geometry and function.
  • To determine if LBBB identifies hypertensive patients with LVH who have poorer cardiac performance.

Main Methods:

  • Echocardiograms were analyzed in 933 hypertensive patients with ECG LVH from the LIFE study.
  • Patients were categorized based on the presence (n=47) or absence (n=886) of LBBB.
  • Multivariate analyses adjusted for clinical and echocardiographic parameters.

Main Results:

  • Patients with LBBB showed significantly lower LV fractional shortening, ejection fraction, midwall shortening, and stroke index.
  • Reduced LV inferior wall motion and impaired LV relaxation (lower mitral E/A ratio) were observed in LBBB patients.
  • These functional deficits were present despite similar LV mass and relative wall thickness between groups.

Conclusions:

  • In hypertensive patients with ECG LVH, LBBB identifies individuals with worse global and regional LV systolic function.
  • LBBB is associated with impaired LV relaxation, independent of LVH severity.
  • LBBB serves as a marker for poorer cardiac function in this high-risk population.

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