Exercise-induced left bundle branch block and subsequent mechanical left ventricular dyssynchrony -resolved with pharmacological therapy

被引：8

作者：

Tanaka, Hidekazu ^{[1
]}

Hiraishi, Mana ^{[1
]}

Miyoshi, Tatsuya ^{[1
]}

Tsuji, Takayuki ^{[1
]}

Kaneko, Akihiro ^{[1
]}

Ryo, Keiko ^{[1
]}

Yamawaki, Kohei ^{[1
]}

Fukuda, Yuko ^{[1
]}

Norisada, Kazuko ^{[1
]}

Tatsumi, Kazuhiro ^{[1
]}

Matsumoto, Kensuke ^{[1
]}

Kawai, Hiroya ^{[1
]}

Hirata, Ken-ichi ^{[1
]}

机构：

[1] Kobe Univ, Grad Sch Med, Dept Internal Med, Div Cardiovasc Med, Kobe, Hyogo 657, Japan

来源：

CARDIOVASCULAR ULTRASOUND | 2011年 / 9卷

关键词：

CARDIAC RESYNCHRONIZATION THERAPY; CORONARY-ARTERY DISEASE; PROGNOSTIC-SIGNIFICANCE; SPECKLE-TRACKING;

D O I：

10.1186/1476-7120-9-4

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

A 53-year-old man with depressed ejection fraction (EF) of 35% and QRS width of 88 ms at rest was admitted to our institution with a complaint of exertional chest discomfort and dyspnea. During treadmill exercise, left bundle-branch block (LBBB) with a QRS width of 152 ms occurred at a heart rate of 100 bpm. During LBBB, the patient showed significant mechanical dyssynchrony as evidenced by a two-dimensional speckle tracking radial strain of 260 ms (>= 130 ms), defined as the time difference between anterior-septum and posterior wall. Five-month after carvedilol and candesartan administration, EF had improved to 49% and LBBB did not occur until a heart rate of 126 bpm was attained during treadmill exercise. It appears that pharmacological therapy may be useful for patients with heart failure and exercise-induced LBBB.

引用

页数：4

共 12 条

[1] Characterization of left ventricular activation in patients with heart failure and left bundle-branch block [J].

Auricchio, A ;

Fantoni, C ;

Regoli, F ;

Carbucicchio, C ;

Goette, A ;

Geller, C ;

Kloss, M ;

Klein, H .

CIRCULATION, 2004, 109 (09) :1133-1139

[2] Bundle-branch block in middle-aged men: risk of complications and death over 28 years - The Primary Prevention Study in Goteborg, Sweden [J].

Eriksson, P ;

Wilhelmsen, L ;

Rosengren, A .

EUROPEAN HEART JOURNAL, 2005, 26 (21) :2300-2306

[3] BUNDLE-BRANCH BLOCK IN PATIENTS WITH CHRONIC CORONARY-ARTERY DISEASE - ANGIOGRAPHIC CORRELATES AND PROGNOSTIC-SIGNIFICANCE [J].

FREEDMAN, RA ;

ALDERMAN, EL ;

SHEFFIELD, LT ;

SAPORITO, M ;

FISHER, LD .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1987, 10 (01) :73-80

[4] Prognostic significance of exercise-induced left bundle-branch block [J].

Grady, TA ;

Chiu, AC ;

Snader, CE ;

Marwick, TH ;

Thomas, JD ;

Pashkow, FJ ;

Lauer, MS .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1998, 279 (02) :153-156

[5] EXERCISE DEPENDENT COMPLETE LEFT-BUNDLE-BRANCH BLOCK [J].

HERTZEANU, H ;

ARON, L ;

SHINER, RJ ;

KELLERMANN, J .

EUROPEAN HEART JOURNAL, 1992, 13 (11) :1447-1451

[6] Complete bundle branch block as an independent predictor of all-cause mortality: Report of 7,073 patients referred for nuclear exercise testing [J].

Hesse, B ;

Diaz, LA ;

Snader, CE ;

Blackstone, EH ;

Lauer, MS .

AMERICAN JOURNAL OF MEDICINE, 2001, 110 (04) :253-259

[7]

LOUBEYRE C, 1991, ANN CARDIOL ANGEIOL, V40, P613

[8]

Munt B, 1997, CAN J CARDIOL, V13, P517

[9] COMPARATIVE FEATURES OF NEWLY ACQUIRED LEFT AND RIGHT BUNDLE-BRANCH BLOCK IN THE GENERAL-POPULATION - THE FRAMINGHAM-STUDY [J].

SCHNEIDER, JF ;

THOMAS, HE ;

SORLIE, P ;

KREGER, BE ;

MCNAMARA, PM ;

KANNEL, WB .

AMERICAN JOURNAL OF CARDIOLOGY, 1981, 47 (04) :931-940

[10] Novel speckle-tracking radial strain from routine black-and-white echocardiographic images to quantify dyssynchrony and predict response to cardiac resynchronization therapy [J].

Suffoletto, MS ;

Dohi, K ;

Cannesson, M ;

Saba, S ;

Gorcsan, J .

CIRCULATION, 2006, 113 (07) :960-968

← 1 2 →