Right bundle branch block and electromechanical coupling of the right ventricle: An echocardiographic study

Miller, Brian Edward; Rajsheker, Srinivas; López‐Candales, Angel

doi:10.4103/1995-705x.172197

Cited by 8 publications

(6 citation statements)

References 33 publications

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“…Although TAPSE was not statistically significant in patients with RBBB, we observed decrease in RBBB than normal individuals. Similar to our results Miller et al (14) demonstrated that RBBB leads to a measurable prolongation of TAPSE in patients without pulmonary hypertension (PH), however it was statistically insignificant (P >0.05). Time-to-peak of TAPSE was not significantly prolonged in patients with PH.…”

Section: Discussionsupporting

confidence: 92%

Evaluation of Right Ventricular Systolic Function in Patients with Right Bundle Branch Block Using Two-Dimensional Speckle Tracking Echocardiography

Elabbady

Aboualia

Attia

2019

The Egyptian Journal of Hospital Medicine

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Background: the prevalence of right bundle branch block (RBBB) is estimated to be 0.2-2.3% in healthy individuals in many previous studies. The prevalence of RBBB increases with age, higher in men, diabetics and in patients with hypertension. Objectives: the purpose of this study was to evaluate the right ventricular systolic function in patients with right bundle branch block with structurally normal heart disease using conventional and speckle tracking 2D echocardiography. Subjects and Methods: forty patients with right bundle branch block (RBBB) were classified into 2 groups each of 20 patients; complete right bundle branch block (CRBBB) and incomplete RBBB (IRBBB), beside 20 normal individuals matched in age and sex served as controls. Results: Tricuspid annular plane systolic excursion (TAPSE) and right ventricle free wall longitudinal strain (RV FWLS) were not statistically significant in patients with RBBB, there was decrease in CRBBB than normal individuals. In right ventricle global longitudinal strain (RV GLS), tricuspid lateral annular systolic velocity (S'), Tei index by both tissue and pulsed Doppler assessment, fractional area change (RV FAC%) and RV basal diameter; and in incomplete right bundle branch block in the mean of RV STE GLS%, S', Tei index by both tissue and pulsed Doppler. Conclusion: Isolated right bundle branch block has an effect on the RV morphologic characteristics, systolic function compared with healthy individuals by 2D, M-mode, Doppler and speckle tracking echocardiographic assessment.

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Section: Discussionsupporting

confidence: 92%

Evaluation of Right Ventricular Systolic Function in Patients with Right Bundle Branch Block Using Two-Dimensional Speckle Tracking Echocardiography

Elabbady

Aboualia

Attia

2019

The Egyptian Journal of Hospital Medicine

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“…Additionally, multiple logistic regression test was performed to determine predictors of abnormal diastolic function. Intra- and inter-observer variability in our echo lab for this patient population has been previously reported [ 25 , 26 ]. A P-value of less than 0.05 was considered statistically significant.…”

Section: Methodsmentioning

confidence: 95%

Left Ventricular Diastolic Function Assessment of a Heterogeneous Cohort of Pulmonary Arterial Hypertension Patients

et al. 2017

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BackgroundPulmonary arterial hypertension (PAH) is known to trigger right ventricular (RV) remodeling that might compromise left ventricular (LV) filling due to inter-ventricular interdependence. In this study, we aimed to examine standard echocardiographic measurements of LV diastolic function in PAH patients.MethodsIn this retrospective study, we identified clinical as well as complete echocardiographic data from 128 chronic PAH patients to fully assess LV diastolic dysfunction (LVDD) using standard recommended Doppler guidelines. Accordingly, patients were divided into three groups: LVDD 0, LVDD 1 and LVDD 2.ResultsThe mean age of the studied population was 57 ± 14 years with a mean pulmonary artery systolic pressure (PASP) of 55 ± 21 mm Hg. A total of 36% of the study patients had normal LV diastolic function. However, 64% had LVDD with LVDD stage 1 being the most common (48%). In terms of echocardiographic data, significant differences were found among the three LVDD groups in regards to PASP, LV end systolic and diastolic volumes, tricuspid annular plane systolic excursion, right ventricular fractional area change as well as many other tissue Doppler imaging parameters. Finally, just age and PASP were predictors of abnormal LV diastolic function (P < 0.05).ConclusionsImpaired relaxation is a common abnormality in PAH patients. Additional studies are warranted to determine whether LVDD alters prognosis or is related to changes in the symptomatic profile of this group of patients.

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“…One possible pathophysiological mechanism for our discovery is that RBBB is more susceptible to dys-synchronized ventricular contractions, resulting in progressive decreased ventricular filling, than LBBB, which in turn leads to an increased risk of developing MACCEs ( Figueroa-Triana et al, 2021 ). Thus, compared to patients with LBBB, this might explain why a new permanent RBBB patient seems more susceptible to ischemic cardiomyopathy ( Miller et al, 2015 ) and at a higher risk for MACCEs and all-cause mortality. In addition, we found that patients with BBB were more likely to have higher levels of triglyceride, while patients with LBBB were more likely to have higher levels of LDL-C and apolipoprotein B.…”

Section: Discussionmentioning

confidence: 99%

New permanent bundle-branch block and long-term prognosis of patients with new onset ST-elevation myocardial infarction who underwent percutaneous coronary intervention

Yang

Wang

et al. 2022

Front. Physiol.

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Aim: The aim of the study was to evaluate the potential predictive value of permanent RBBB and LBBB for longer-term prognosis in patients with new-onset STEMI who underwent percutaneous coronary intervention (PCI).Methods: Patients with new-onset STEMI that underwent emergency PCI at our department from June 2012 to September 2020 were included in the study. Gensini score (GS) was employed to evaluate the severity of coronary lesions. The primary endpoint of the study was the occurrence of major adverse cardiac and cerebrovascular events (MACCEs), the composite of cardiac mortality, recurrence of myocardial infarction, cardiac shock, stroke, stent thrombosis, or revascularization. We also set all-cause mortality as a secondary endpoint.Results: Out of the 547 patients, 29 patients had new-onset permanent LBBB, 51 patients had new-onset permanent RBBB, and 467 patients had no bundle-branch block (BBB). The occurrence of no BBB, new permanent LBBB, or RBBB was not associated with the severity of coronary artery lesions as evaluated by the GS. After follow-up at an average of 43.93 months, MACCEs occurred in 52 patients. Kaplan-Meier analysis showed that patients with new-onset RBBB were at greater risk for MACCEs compared to those with new onset LBBB (χ2 = 5.107, p = 0.021). Also, an independent correlation was found between new permanent RBBB and LBBB and MACCEs risk. The adjusted hazard ratios (HRs) were 6.862 [95% confidence interval (CI) of 3.764–12.510] for the new-onset permanent RBBB and 3.395 (95% CI of 1.280–9.005) for LBBB, compared to those with no BBB, respectively (both p < 0.05).Conclusion: New onset permanent RBBB in patients with new onset STEMI who underwent PCI may be correlated independently with increased risk of poor long-term prognosis.

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Right bundle branch block and electromechanical coupling of the right ventricle: An echocardiographic study

Cited by 8 publications

References 33 publications

Evaluation of Right Ventricular Systolic Function in Patients with Right Bundle Branch Block Using Two-Dimensional Speckle Tracking Echocardiography

Evaluation of Right Ventricular Systolic Function in Patients with Right Bundle Branch Block Using Two-Dimensional Speckle Tracking Echocardiography

Left Ventricular Diastolic Function Assessment of a Heterogeneous Cohort of Pulmonary Arterial Hypertension Patients

New permanent bundle-branch block and long-term prognosis of patients with new onset ST-elevation myocardial infarction who underwent percutaneous coronary intervention

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