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European Journal of Heart Failure 2005 7(2):225-230; doi:10.1016/j.ejheart.2004.07.003
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© 2005 European Society of Cardiology

Global and regional myocardial oxygen consumption and blood flow in severe cardiomyopathy with left bundle branch block

Oliver Lindnera,*, Jürgen Vogtb, Detlev Ballerb, Annett Kammeiera, Peter Wieleppa, Jens Holzingerb, Barbara Lampb, Dieter Horstkotteb and Wolfgang Burcherta

a Institute of Molecular Biophysics, Radiopharmacy and Nuclear Medicine, Heart and Diabetes Center North Rhine-Westphalia Georgstr. 11, D-32545 Bad Oeynhausen, Germany
b Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia Bad Oeynhausen, Germany

* Corresponding author. Tel.: +49 5731 97 1309; fax.: +49 5731 97 2190. E-mail address: olindner{at}hdz-nrw.de


  Abstract

Objective: In patients with dilated cardiomyopathy (DCM), left bundle branch block (LBBB) is a common finding. The characteristic feature is an asynchronous septal wall motion and most frequently a delay of the lateral and/or posterior wall segments. With the onset of cardiac resynchronization therapy, there is a focus on the specific pathophysiology of a LBBB. However, quantitative data on regional myocardial oxygen consumption (MVO2) and blood flow (MBF) are missing.

Methods: We studied 31 patients with severe DCM and LBBB (ejection fraction 22.1±7.1%) and 14 patients with mild to moderate DCM without LBBB (ejection fraction 46.7±7.9%). Global and regional MVO2 as well as MBF were determined from a dynamic 11C-acetate positron emission tomography (PET) study.

Results: Global MVO2 and MBF were lower in the DCM group with LBBB than in the control group (P<0.05). Regionally, the LBBB group revealed a higher (P<0.05) MVO2 and MBF in the lateral wall than in the other walls. The control group did not show significant differences between the myocardial walls and demonstrated a smaller variability of the parameters.

Conclusion: DCM patients with LBBB exhibit a more heterogeneous distribution of MVO2 and MBF among the myocardial walls than DCM patients without LBBB. Due to the LBBB associated electromechanical alterations, the highest regional values of MVO2 and MBF are found in the lateral wall.

Key Words: Cardiomyopathy • Conduction system • Oxygen consumption • Blood flow

Received November 24, 2003; Revised February 18, 2004; Accepted July 5, 2004


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