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Related Experiment Videos

[Interventricular septal wall motion abnormality in left bundle branch block].

K Ikeoka1, M Tanimoto, Y Nomoto

  • 1First Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya.

Journal of Cardiology
|December 1, 1987
PubMed
Summary
This summary is machine-generated.

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Left bundle branch block (LBBB) causes interventricular septum perfusion defects by altering myocardial blood flow. Right ventricular pacing in LBBB models reduced septal blood flow, impacting cardiac function.

Area of Science:

  • Cardiovascular Physiology
  • Myocardial Perfusion Imaging
  • Cardiac Electrophysiology

Background:

  • Left bundle branch block (LBBB) can cause perfusion defects on T1-201 scintigraphy, even with normal coronary arteries.
  • The underlying mechanism of these septal perfusion defects in LBBB is not fully understood.

Purpose of the Study:

  • To investigate the mechanism of interventricular septum perfusion defects observed in left bundle branch block (LBBB) patients with normal coronary arteries.
  • To assess regional myocardial blood flow (MBF) and interventricular septum pressure dynamics during LBBB induction.

Main Methods:

  • Experimental study in anesthetized open-chest dogs.
  • Simulated LBBB via right ventricular pacing, RBBB via left ventricular pacing, and control (right atrial pacing).

Related Experiment Videos

  • Measured interventricular septum intramuscular pressure, LAD blood flow, and regional MBF (septum, LAD, LCx areas) using H2-washout.

    • Main Results:

    • Right ventricular pacing (LBBB model) decreased septal MBF (99.6 to 79.2 ml/min/100 g) and increased LCx MBF (103.2 to 122 ml/min/100 g).
    • LAD flow remained unchanged during right ventricular pacing.
    • Septal wall showed an early systolic dip during right ventricular pacing, preceding the rise in left ventricular pressure.

    Conclusions:

    • Right ventricular pacing, mimicking LBBB, alters regional myocardial blood flow distribution, specifically reducing flow to the interventricular septum.
    • The observed septal pressure changes and delayed left ventricular pressure rise during LBBB induction suggest mechanical factors contribute to perfusion defects.