PMID- 22975099
OWN - NLM
STAT- MEDLINE
DCOM- 20130404
LR  - 20131121
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Linking)
VI  - 31
IP  - 10
DP  - 2012 Oct
TI  - Relationship between mechanical and metabolic dyssynchrony with left bundle 
      branch block: evaluation by 18-fluorodeoxyglucose positron emission tomography in 
      patients with non-ischemic heart failure.
PG  - 1096-101
LID - S1053-2498(12)01174-6 [pii]
LID - 10.1016/j.healun.2012.07.002 [doi]
AB  - BACKGROUND: Ventricular dyssynchrony is a common finding in patients with heart 
      failure (HF), especially in the presence of conduction delays. The loss of 
      ventricular synchrony leads to progressive impairment of contractile function, 
      which may be explained in part by segmental abnormalities of myocardial 
      metabolism. However, the association of these metabolic disarrangements with 
      parameters of ventricular dyssynchrony and electrocardiography (ECG) findings has 
      not yet been studied. METHODS: Our aim was to determine the correlation between 
      the presence of left bundle branch block (LBBB) with left ventricular (LV) 
      mechanical synchrony assessed by multiple-gated acquisition scan (MUGA) and with 
      patterns of 18-fluorodeoxyglucose (18FDG) uptake in patients with non-ischemic 
      heart failure. Twenty-two patients with non-ischemic cardiomyopathy, LV ejection 
      fraction (LVEF) </=45% and New York Heart Association (NYHA) Functional Class II or 
      III symptoms under standard medical therapy were included, along with 10 healthy 
      controls matched for age and gender. A 12-lead ECG was obtained to measure the 
      length of the QRS. Mechanical LV synchrony was assessed by MUGA using phase 
      analysis. All patients and controls underwent positron emission tomography with 
      18FDG to determine the distribution of myocardial glucose uptake. The standard 
      deviation of peak (18)FDG uptake was used as an index of metabolic heterogeneity. 
      Student's t-test and Pearson's correlation were used for statistical analysis. 
      RESULTS: The mean age of the patients with HF was 54 +/- 12 years and 72% were 
      male. The length of the QRS was 129 +/- 31 milliseconds and LBBB was present in 9 
      patients. Patients with HF had decreased LV 18FDG uptake compared with controls 
      (7.56 +/- 3.36 vs. 11.63 +/- 4.55 standard uptake value; p = 0.03). The length of the 
      QRS interval correlated significantly with glucose uptake heterogeneity (r = 
      0.62; p = 0.002) and mechanical dyssynchrony (r = 0.63; p = 0.006). HF patients 
      with LBBB showed marked glucose uptake heterogeneity compared with HF patients 
      without LBBB (41.4 +/- 10 vs 34.7 +/- 4.9 ml/100 g/min, respectively; p = 0.01). 
      CONCLUSIONS: Patients with non-ischemic heart failure exhibit a global decrease 
      in myocardial glucose uptake. Within this group, subjects who also have LBBB 
      exhibit a marked heterogeneity in segmental glucose uptake, which directly 
      correlates with QRS duration.
CI  - Copyright (c) 2012 International Society for Heart and Lung Transplantation. 
      Published by Elsevier Inc. All rights reserved.
FAU - Castro, Pablo
AU  - Castro P
AD  - Division Enfermedades Cardiovasculares; Departamento Medicina Nuclear, Facultad 
      de Medicina, Pontificia Universidad Catolica, Santiago, Chile. pcastro@med.puc.cl
FAU - Winter, Jose Luis
AU  - Winter JL
FAU - Verdejo, Hugo
AU  - Verdejo H
FAU - Orellana, Pilar
AU  - Orellana P
FAU - Quintana, Juan Carlos
AU  - Quintana JC
FAU - Greig, Douglas
AU  - Greig D
FAU - Enriquez, Andres
AU  - Enriquez A
FAU - Sepulveda, Luis
AU  - Sepulveda L
FAU - Concepcion, Roberto
AU  - Concepcion R
FAU - Sepulveda, Pablo
AU  - Sepulveda P
FAU - Rossel, Victor
AU  - Rossel V
FAU - Chiong, Mario
AU  - Chiong M
FAU - Garcia, Lorena
AU  - Garcia L
FAU - Lavandero, Sergio
AU  - Lavandero S
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
RN  - 0Z5B2CJX4D (Fluorodeoxyglucose F18)
RN  - IY9XDZ35W2 (Glucose)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Bundle-Branch Block/*metabolism/*physiopathology
MH  - Case-Control Studies
MH  - Electrocardiography
MH  - Female
MH  - Fluorodeoxyglucose F18/metabolism
MH  - Glucose/metabolism
MH  - Heart Failure/*metabolism/*physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Positron-Emission Tomography
MH  - Stroke Volume/physiology
MH  - Ventricular Dysfunction, Left/*metabolism/*physiopathology
EDAT- 2012/09/15 06:00
MHDA- 2013/04/05 06:00
CRDT- 2012/09/15 06:00
PHST- 2012/03/16 00:00 [received]
PHST- 2012/05/30 00:00 [revised]
PHST- 2012/07/17 00:00 [accepted]
PHST- 2012/09/15 06:00 [entrez]
PHST- 2012/09/15 06:00 [pubmed]
PHST- 2013/04/05 06:00 [medline]
AID - S1053-2498(12)01174-6 [pii]
AID - 10.1016/j.healun.2012.07.002 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2012 Oct;31(10):1096-101. doi: 
      10.1016/j.healun.2012.07.002.