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Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction
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Global and regional myocardial oxygen consumption and blood flow in severe cardiomyopathy with left bundle branch

Oliver Lindner1, Jürgen Vogt, Detlev Baller

  • 1Institute of Molecular Biophysics, Radiopharmacy and Nuclear Medicine, Heart and Diabetes Center North Rhine-Westphalia, Georgstr. 11, D-32545 Bad Oeynhausen, Germany. olindner@hdz-nrw.de

European Journal of Heart Failure
|February 11, 2005
PubMed

Insights

Patients with dilated cardiomyopathy and left bundle branch block show uneven oxygen use and blood flow in the heart muscle. The lateral wall has the highest regional myocardial oxygen consumption and blood flow.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Biomedical Engineering

Background:

  • Dilated cardiomyopathy (DCM) frequently presents with left bundle branch block (LBBB), causing asynchronous septal wall motion.
  • LBBB is associated with delayed motion in lateral and/or posterior wall segments.
  • Understanding LBBB's pathophysiology is crucial for cardiac resynchronization therapy, yet quantitative data on regional myocardial oxygen consumption (MVO(2)) and blood flow (MBF) are lacking.

Purpose of the Study:

  • To quantitatively assess regional myocardial oxygen consumption (MVO(2)) and blood flow (MBF) in patients with DCM and LBBB.
  • To compare MVO(2) and MBF distribution in DCM patients with and without LBBB.

Main Methods:

  • Studied 31 severe DCM patients with LBBB (ejection fraction 22.1±7.1%) and 14 mild-to-moderate DCM patients without LBBB (ejection fraction 46.7±7.9%).
  • Determined global and regional MVO(2) and MBF using dynamic (11)C-acetate positron emission tomography (PET).

Main Results:

  • Global MVO(2) and MBF were significantly lower in DCM patients with LBBB compared to controls (P<0.05).
  • The LBBB group exhibited higher regional MVO(2) and MBF in the lateral wall compared to other walls (P<0.05).
  • Control group showed no significant inter-wall differences and less parameter variability.

Conclusions:

  • DCM patients with LBBB demonstrate a more heterogeneous MVO(2) and MBF distribution across myocardial walls than those without LBBB.
  • Electromechanical alterations due to LBBB lead to the highest regional MVO(2) and MBF values observed in the lateral wall.
Abstract

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