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Mechanical dyssynchrony alters left ventricular flow energetics in failing hearts with LBBB: a 4D flow CMR pilot study.
Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US.ORCID-id: 0000-0003-1395-8296
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2018 (engelsk)Inngår i: The International Journal of Cardiovascular Imaging, ISSN 1569-5794, E-ISSN 1875-8312, Vol. 34, nr 4, s. 587-596Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

The impact of left bundle branch block (LBBB) related mechanical dyssynchrony on left ventricular (LV) diastolic function remains unclear. 4D flow cardiovascular magnetic resonance (CMR) has provided reliable markers of LV dysfunction: reduced volume and kinetic energy (KE) of the portion of LV inflow which passes directly to outflow (Direct Flow) has been demonstrated in failing hearts compared to normal hearts. We sought to investigate the impact of mechanical dyssynchrony on diastolic function by comparing 4D flow in myopathic LVs with and without LBBB. CMR data were acquired at 3 T in 22 heart failure patients; 11 with LBBB and 11 without LBBB matched according to several demographic and clinical parameters. An established 4D flow analysis method was used to separate the LV end-diastolic (ED) volume into functional flow components based on the blood's timing and route through the heart cavities. While the Direct Flow volume was not different between the groups, the KE possessed at ED was lower in LBBB patients (P = 0.018). Direct Flow entering the LV during early diastolic filling possessed less KE at ED in LBBB patients compared to non-LBBB patients, whereas no intergroup difference was observed during late filling. Pre-systolic KE of LV Direct Flow was reduced in patients with LBBB compared to matched patients with normal conduction. These intriguing findings propose that 4D flow specific measures can serve as markers of LV mechanical dyssynchrony in heart failure patients, and could possibly be investigated as predictors of response to cardiac resynchronization therapy.

sted, utgiver, år, opplag, sider
Springer, 2018. Vol. 34, nr 4, s. 587-596
Emneord [en]
4D flow CMR, Heart failure, Left bundle branch block, Left ventricular mechanical dyssynchrony
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Identifikatorer
URN: urn:nbn:se:liu:diva-145873DOI: 10.1007/s10554-017-1261-5ISI: 000427902300012PubMedID: 29098524OAI: oai:DiVA.org:liu-145873DiVA, id: diva2:1194993
Merknad

Funding agencies: Swedish Heart and Lung Foundation [20140398]; Swedish Research Council [621-2014-6191]; European Research Council [310612]

Tilgjengelig fra: 2018-04-04 Laget: 2018-04-04 Sist oppdatert: 2019-05-07

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Zajac, JakubEriksson, JonatanAlehagen, UrbanEbbers, TinoBolger, Ann FCarlhäll, Carljohan
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