Assessment of left ventricular mechanics and energetics in various types of left bundle branch block using echocardiography
Shehata, M., Nawar, M., Badano, L., El Sharkawy, E., Abo elhoda, A. (2020). Assessment of left ventricular mechanics and energetics in various types of left bundle branch block using echocardiography. EKB Journal Management System, 2(2), 1-14. doi: 10.21608/muj.2020.28821.1009
Mahmoud Shehata Abd El Hamid Shehata; Mustapha Mohamed Nawar; Luigi Paolo Badano; Eman Mohamed El Sharkawy; Aly Ahmed Abo elhoda. "Assessment of left ventricular mechanics and energetics in various types of left bundle branch block using echocardiography". EKB Journal Management System, 2, 2, 2020, 1-14. doi: 10.21608/muj.2020.28821.1009
Shehata, M., Nawar, M., Badano, L., El Sharkawy, E., Abo elhoda, A. (2020). 'Assessment of left ventricular mechanics and energetics in various types of left bundle branch block using echocardiography', EKB Journal Management System, 2(2), pp. 1-14. doi: 10.21608/muj.2020.28821.1009
Shehata, M., Nawar, M., Badano, L., El Sharkawy, E., Abo elhoda, A. Assessment of left ventricular mechanics and energetics in various types of left bundle branch block using echocardiography. EKB Journal Management System, 2020; 2(2): 1-14. doi: 10.21608/muj.2020.28821.1009

Assessment of left ventricular mechanics and energetics in various types of left bundle branch block using echocardiography

Medicine Updates
Article 11, Volume 2, Issue 2, July 2020, Page 1-14  XML PDF (844.45 K)
Document Type: Research project
DOI: 10.21608/muj.2020.28821.1009
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Authors
Mahmoud Shehata Abd El Hamid Shehata email 1; Mustapha Mohamed Nawar2; Luigi Paolo Badano3; Eman Mohamed El Sharkawy2; Aly Ahmed Abo elhoda2
1cardiology department, faculty of medicine, port said university, port said, Egypt.
2cardiology department, faculty of medicine, Alexandria university, Egypt
3cardiac, thoracic and vascular science department, faculty of medicine, Padova university, Italy
Abstract
One third of patients meeting conventional electrocardiographic criteria for LBBB may be misdiagnosed and new ECG criteria for LBBB have been proposed (Strauss’s criteria). We used 2D speckle tracking echocardiography (2DSTE), to compare LV mechanics in LBBB with conventional versus Strauss’s criteria.We studied 49 asymptomatic patients with LBBB: 16 with conventional (mean age 69 years, 56% were men) and 33 with Strauss’s criteria (mean age 66 years, 61% were men), LVEF>45%, and no significant obstructive CAD. 3D echo was performed to measure LV end diastolic (LVEDV) and end systolic (LVESV) volumes, sphericity index (SpI), LV remodelling index (LVRI) and LVEF. 2DSTE was used to measure parameters of LV dyssynchrony: septal to posterior wall time to peak radial strain (SW-PW delay), longitudinal strain delay index (L-SDI), longitudinal strain rate dispersion index (L-SRDI) and LV mechanical dispersion (LVMD). We also measured LV cardiac work indices: global work efficiency (GWE), global work index (GWI), global constructive work (GCW), and global wasted work (GWW).L-SDI was significantly higher in patients with Strauss’s criteria than in conventional one (3717% vs 2510%, respectively, p = 0.007). GWW tended to be higher in patients with Strauss’s criteria than in conventional one (325132% vs 267124% respectively, p = 0.079).LVESV index was positively correlated with GWW (p= 0.001). So, Patients in whom LBBB was diagnosed according to Strauss’s criteria showed significantly higher intraventricular dyssynchrony and tendency for higher LV wasted work than patients with LBBB according to conventional criteria.
Keywords
Left bundle branch block; Strauss; Dys-synchrony; Echocardiography; Left ventricular mechanics
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