Exercise-induced left bundle branch block and subsequent mechanical left ventricular dyssynchrony -resolved with pharmacological therapyReport as inadecuate




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Cardiovascular Ultrasound

, 9:4

First Online: 07 February 2011Received: 14 January 2011Accepted: 07 February 2011

Abstract

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.

List of abbreviationsEFejection fraction

LBBBleft bundle-branch block

LVleft ventricular.

Electronic supplementary materialThe online version of this article doi:10.1186-1476-7120-9-4 contains supplementary material, which is available to authorized users.

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Author: Hidekazu Tanaka - Mana Hiraishi - Tatsuya Miyoshi - Takayuki Tsuji - Akihiro Kaneko - Keiko Ryo - Kohei Yamawaki - Yuko Fu

Source: https://link.springer.com/article/10.1186/1476-7120-9-4







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