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Left bundle branch block: angiographic segmental wall motion abnormalities.

R S Williams, V S Behar, R H Peter

    The American Journal of Cardiology
    |November 1, 1979
    PubMed
    Summary
    This summary is machine-generated.

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    Left bundle branch block (LBBB) can cause abnormal ventricular wall motion, even without heart disease. This study found regional wall motion abnormalities in most LBBB patients, suggesting activation sequence as a cause.

    Area of Science:

    • Cardiology
    • Cardiac Electrophysiology
    • Diagnostic Imaging

    Background:

    • Previous studies using contrast ventriculography reported normal ventricular wall motion in left bundle branch block (LBBB) patients without coronary artery disease or cardiomyopathy.
    • Recent echocardiographic studies suggest a high prevalence of septal wall asynergy in LBBB patients.

    Purpose of the Study:

    • To investigate left ventricular (LV) wall motion in patients with LBBB and no significant coronary artery disease or diffuse cardiomyopathy.
    • To compare LV wall motion between LBBB patients and controls with normal intraventricular conduction.

    Main Methods:

    • Analysis of biplane cineangiograms from 15 LBBB patients and 100 controls.
    • Utilized both qualitative visual inspection and computer-assisted quantitative methods for wall motion assessment.

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  • Compared wall motion along defined hemiaxes.

    • Main Results:

    • Qualitative review revealed regional akinesia or dyskinesia in 6 of 15 LBBB patients versus none of 100 controls (P < 0.001).
    • Quantitative review showed abnormal wall motion in 10 of 12 LBBB patients along at least one hemiaxis.
    • Significant difference in regional wall motion abnormalities between LBBB patients and controls.

    Conclusions:

    • Angiographic regional wall motion abnormalities are common in LBBB patients, irrespective of coronary artery disease or cardiomyopathy.
    • Abnormalities may stem from the altered sequence of ventricular activation, not necessarily myocardial fibrosis.