Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.
Sci Rep. 2017 Jul 19;7(1):5936. doi: 10.1038/s41598-017-06362-1.
A leftward motion of the ventricular septum prior to ejection, known as the septal flash (SF), is frequently observed in patients with left bundle-branch block (LBBB). We investigated whether the abnormal motion of the ventricular septum affects right ventricle (RV) contractile performance in LBBB patients with preserved left ventricular ejection fraction (LVEF). Forty-four patients with complete LBBB were selected using standard 12-lead electrocardiograms (ECGs), with 30 healthy individuals serving as controls. According to the presence of SF, patients with LBBB were allocated to two subgroups: those with SF (LBBB-SF, n = 24) and those without SF (LBBB-NSF, n = 20). RV longitudinal strain (LS) decreased in LBBB patients with preserved LVEF compared to control subjects (p = 0.002). And RV LS decreased significantly in LBBB-SF patients compared to NSF-LBBB patients (p = 0.04). RV LS correlated negatively with involved septal myocardial segments of SF (r = -0.36, p = 0.02), but did not correlate with the magnitude of SF. RV contractile performance deceased in LBBB patients with preserved LVEF. SF, particularly the extent of this phenomenon, may further affect RV contractile performance.
左心室室间隔在射血前向左运动，称为室间隔闪烁（SF），在左束支传导阻滞（LBBB）患者中经常观察到。我们研究了左心室射血分数（LVEF）正常的 LBBB 患者中室间隔的异常运动是否影响右心室（RV）收缩功能。使用标准 12 导联心电图（ECG）选择了 44 例完全性 LBBB 患者，30 例健康个体作为对照。根据 SF 的存在，将 LBBB 患者分为两组：有 SF 的 LBBB 患者（LBBB-SF，n=24）和无 SF 的 LBBB 患者（LBBB-NSF，n=20）。与对照组相比，LVEF 正常的 LBBB 患者的 RV 纵向应变（LS）降低（p=0.002）。并且，与 NSF-LBBB 患者相比，LBBB-SF 患者的 RV LS 明显降低（p=0.04）。RV LS 与 SF 涉及的间隔心肌节段呈负相关（r=-0.36，p=0.02），但与 SF 的幅度无关。LVEF 正常的 LBBB 患者的 RV 收缩功能下降。SF，尤其是这种现象的程度，可能会进一步影响 RV 的收缩功能。
