As stated in the summary of the thesis written by Dr. Moene Aalen
branch block (LBBB) is a common finding in clinical cardiology practice and may
lead to or worsen heart failure. During LBBB, there is typically reduced
function in the early-activated interventricular septum and compensatory
increased function in the late-activated left ventricular (LV) lateral wall,
but the effect of LBBB on global LV function is incompletely understood. In
LBBB patients with symptomatic heart failure, cardiac resynchronization therapy
(CRT) is indicated, but about one third of patients do not respond.
The aim of
the present thesis was to study the effect of LBBB on LV function during
increased blood pressure and ischemia, and to find a better method to select
found that patients with LBBB were hypersensitive to a moderate blood pressure
increase as this caused a substantial reduction in LV ejection fraction, which
was approximately twice of what was seen in age-matched controls. The
underlying mechanism was septal dysfunction.
found that septal dysfunction in LBBB is highly dependent on contractions in
the lateral wall. Thus, during lateral wall ischemia, septal function was
Third, in a
prospective multicenter study, we demonstrated how the presence of marked
septal dysfunction with compensatory lateral wall hyperfunction identified
patients who responded to CRT with added value to current guidelines. The
mechanism of CRT response was increased septal function and consequently
patients with septal scar responded poorly.
the findings in the thesis improve understanding of heart failure and CRT
response in patients with LBBB.
Read more Public Digital Defence: John Moene
Aalen - Institute of Clinical Medicine (uio.no)