AI Article Synopsis
- Left bundle branch block (LBBB) is a common heart condition that raises concerns about its link to cardiomyopathy and specifically how it might initiate dilated cardiomyopathy.
- The study involved inducing LBBB in 14 dogs, monitoring their heart function and structural changes at multiple time points to understand the effects on left ventricular function and potential pathological mechanisms.
- Results showed that LBBB caused significant heart tissue damage and progressive left ventricular dysfunction over 12 months, revealing a complex relationship between LBBB and cardiomyopathy that could guide future clinical research and treatments.
Article Abstract
Background: Left bundle branch block (LBBB) represents a frequently encountered conduction system disorder. Despite its widespread occurrence, a continual dilemma persists regarding its intricate association with underlying cardiomyopathy and its pivotal role in the initiation of dilated cardiomyopathy. The pathologic alterations linked to LBBB-induced cardiomyopathy (LBBB-CM) have remained elusive.
Objective: This study sought to investigate the chronologic dynamics of LBBB to left ventricular dysfunction and the pathologic mechanism of LBBB-CM.
Methods: LBBB model was established through main left bundle branch trunk ablation in 14 canines. All LBBB dogs underwent transesophageal echocardiography and electrocardiography before ablation and at 1 month, 3 months, 6 months, and 12 months after LBBB induction. Single-photon emission computed tomography imaging was performed at 12 months. We then harvested the heart from all LBBB dogs and 14 healthy adult dogs as normal controls for anatomic observation, Purkinje fiber staining, histologic staining, and connexin43 protein expression quantitation.
Results: LBBB induction caused significant fibrotic changes in the endocardium and mid-myocardium. Purkinje fibers exhibited fatty degeneration, vacuolization, and fibrosis along with downregulated connexin43 protein expression. During a 12-month follow-up, left ventricular dysfunction progressively worsened, peaking at the end of the observation period. The association between myocardial dysfunction, hypoperfusion, and fibrosis was observed in the LBBB-afflicted canines.
Conclusion: LBBB may lead to profound myocardial injury beyond its conduction impairment effects. The temporal progression of left ventricular dysfunction and the pathologic alterations observed shed light on the complex relationship between LBBB and cardiomyopathy. These findings offer insights into potential mechanisms and clinical implications of LBBB-CM.
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| http://dx.doi.org/10.1016/j.hrthm.2024.03.012 | DOI Listing |
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