Magnetic Resonance Imaging Correlates of Left Bundle Branch Disease in Patients With Nonischemic Cardiomyopathy

Grigoratos, Chrysanthos; Liga, Riccardo; Bennati, Elena; Barison, Andrea; Todiere, Giancarlo; Aquaro, Giovanni Donato; Dell’Omodarme, M.; Emdin, Michele; Masci, Pier Giorgio

doi:10.1016/j.amjcard.2017.10.024

Cited by 9 publications

(6 citation statements)

References 26 publications

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“…Similarly, a prior investigation documented more dilation of the LV and lesser dilation of the RV in individuals with LBBB. 11 In contrast to our results, LBBB patients had a greater reduction in LVEF. However, that investigation included patients across the entire range of reduced LVEF while grouping together patients with LBBB and left anterior fascicular block in the analysis.…”

Section: Discussioncontrasting

confidence: 99%

“…While one study failed to establish a correlation between these two parameters, 16 another smaller study proposed that LBBB patients may have a greater prevalence of septal non-ischaemic LGE, despite exhibiting similar degrees of fibrosis in the remaining segments. 11 Another recent study examining the relationship between CMR-derived scar and response to CRT also found no difference in the overall scar percentage between patients with or without LBBB. However, in contrast to our results, this research demonstrated that septal scarring was more prevalent in patients with LBBB.…”

Section: Discussionmentioning

confidence: 96%

“…However, that investigation included patients across the entire range of reduced LVEF while grouping together patients with LBBB and left anterior fascicular block in the analysis. 11 Nevertheless, it is noteworthy that the characteristics of individuals with mildly reduced LVEF differed from those within more severely reduced LVEF categories. 1 In patients with LBBB, LVEF is disproportionately decreased relative to the extent of the scar, according to a recent study.…”

Section: Discussionmentioning

confidence: 98%

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CMR characterization of patients with heart failure and left bundle branch block

Tomoaia,

Harrison,

Bevis

et al. 2024

European Heart Journal - Imaging Methods and Practice

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Aims We aimed to identify the distinctive cardiovascular magnetic resonance (CMR) features of patients with left bundle branch block (LBBB) and heart failure with reduced ejection fraction (HFrEF) of presumed non-ischaemic aetiology. The secondary aim was to determine whether these individuals exhibit characteristics that could potentially serve as predictors of left ventricular ejection fraction (LVEF) recovery as compared to patients without LBBB. Methods We prospectively recruited patients with HFrEF (LVEF ≤40%) on echocardiography who were referred for early CMR examination. Patients with an established diagnosis of coronary artery disease and known structural or congenital heart disease were excluded. LV recovery was defined as achieving ≥10% absolute improvement to ≥40% in LVEF between baseline evaluation to CMR. Results A total of 391 patients were recruited including 115 (29.4%) with LBBB. Compared to HF patients without LBBB, those with LBBB exhibited larger left ventricles and smaller right ventricles, but no differences were observed with respect to LVEF (35.8 ± 12 vs. 38 ± 12 %, p=0.105). The overall rate of LV recovery from baseline echocardiogram to CMR (70 [42 - 128] days) was not significantly different between LBBB and non-LBBB patients (27.8% vs. 31.5%, p=0.47). Reduced LVEF remained an independent predictor of LV non-recovery only in patients with LBBB. Conclusion Patients presenting with HFrEF and LBBB had larger LV cavities and smaller RV cavities than those without LBBB but no difference in prevalence of scar or ischaemia. The rates of LV recovery were similar between both groups, which supports current guidelines to defer device therapy until 3-6 months of GDMT, rather than early CMR and device implantation.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 98%

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CMR characterization of patients with heart failure and left bundle branch block

Tomoaia,

Harrison,

Bevis

et al. 2024

European Heart Journal - Imaging Methods and Practice

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“…Interestingly, as pointed out by some reports, 6–8 an LBBB with a prominent R-wave in V1 was observed in patients with septal fibrosis. Grigoratos et al 9 in a cohort of 196 patients with non-ischaemic cardiomyopathy submitted to CMR, observed that patients with left bundle disease (left anterior hemiblock or complete LBBB) were associated with a higher LV septal scar burden on CMR compared to patients with normal intra-ventricular conduction.…”

Section: Conduction Disturbancesmentioning

confidence: 99%

The electrocardiogram in non-ischaemic-dilated cardiomyopathy

Crescenzi

Silvetti

Romeo

et al. 2023

European Heart Journal Supplements

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This article summarizes the main electrocardiogram (ECG) findings in dilated cardiomyopathy (DCM) patients. Recent reports are described in the great ‘pot’ of DCM peculiar ECG patterns that are typical of specific forms of DCM. Patients with late gadolinium enhancement on CMR, who are at greatest arrhythmic risk, have also distinctive ECG features. Future studies in large DCM populations should evaluate the diagnostic and prognostic value of the ECG.

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“…LGE was observed more commonly in patients with LBBB (n = 83) compared to patients with normal intraventricular conduction (n = 84) and was more often located in the ventricular septum (P \ 0.001). 11 The authors suggested that septal fibrosis on CMR might reflect the underlying anatomic interruption of the proximal His-bundle network and Figure 1. Case example with anteroseptal perfusion defect on regadenoson stress and rest Tc-99m sestamibi D-SPECT-MPI in a 77-year-old female with left bundle branch block.…”

mentioning

confidence: 99%

Elucidating the pathophysiology of left bundle branch block related perfusion defects

Otaki

Miller

Slomka

2021

Journal of Nuclear Cardiology

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Magnetic Resonance Imaging Correlates of Left Bundle Branch Disease in Patients With Nonischemic Cardiomyopathy

Cited by 9 publications

References 26 publications

CMR characterization of patients with heart failure and left bundle branch block

CMR characterization of patients with heart failure and left bundle branch block

The electrocardiogram in non-ischaemic-dilated cardiomyopathy

Elucidating the pathophysiology of left bundle branch block related perfusion defects

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