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[Left ventricular kinetics in bundle-branch block. Analysis by different methods in patients without coronary artery
Abstract:
Radiological ventriculographic findings of twenty-three patients with left bundle branch block (LBBB) without valvular heart disease and without evident coronarographic lesions are studied by means of six differents methods for quantitative evaluation of wall motion analysis. The patients are subdivided into two subgroups on the basis of hemodynamic criteria, but the results of wall motion studies are similar in both, if the values obtained are normalized for election fraction (EF). End-diastolic images of left ventricle are similar in both subgroups too, but very different from those of normals because apical region is characterized by rounded contour of images. The modes of contractility in LBBB patients evidence, after normalization by the same EF, hypercinetic motility of anterior wall. The patterns of contractility, shaped by progressive simulated EF, show that low EF are obtained through contraction of anterior wall. Greater EF are obtained by further uniform contraction of all the explored regions. The apical zone in LBBB patients is affected by persistent hypokinesis.