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ACC/AHA 2008 Performance Measures for Adults With ST-Elevation and Non–ST-Elevation Myocardial Infarction

ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease
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J Am Coll Cardiol, 2007; 50:1484-1490, doi:10.1016/j.jacc.2007.07.011 (Published online 21 September 2007).
© 2007 by the American College of Cardiology Foundation
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Diminished Left Ventricular Dyssynchrony and Impact of Resynchronization in Failing Hearts With Right Versus Left Bundle Branch Block

Melissa J. Byrne, PhD*,2, Robert H. Helm, MD*,2, Samantapudi Daya, MD*, Nael F. Osman, PhD§,||, Henry R. Halperin, MD, MA, FAHA*,{dagger},§, Ronald D. Berger, MD, PhD*, David A. Kass, MD, FAHA*,{dagger},1 and Albert C. Lardo, PhD, FACC, FAHA*,{dagger},{ddagger},§,1,*

* Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
{dagger} Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland
{ddagger} Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
§ Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
|| Department of Electrical and Computer Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland.


Figure 1
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  		Figure 1 Strain Plots Comparing Mechanical Dyssynchrony in Failing Hearts With RBBB and LBBB

Temporal strain maps for (A) left bundle branch block (LBBB) + heart failure; (B) right bundle branch block (RBBB) + heart failure during right atrial pacing; (C) corresponding LBBB + heart failure strain plot; and (D) corresponding RBBB + heart failure strain plot during early and late systole.

 

Figure 2
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  		Figure 2 Comparison of Regional and Global Strain in Failing Hearts With RBBB and LBBB

Time to peak strain as a percentage of R-R interval for (A) RBBB + heart failure; (B) LBBB + heart failure; and (C) the standard deviation of time to peak strain for RBBB + heart failure and LBBB + heart failure. (D) Examples of mechanical activation delay maps for both RBBB and LBBB (see text for details). Color bar: blue = early activation; red = late activation. Data expressed as mean ± standard error of the mean. (A and B) *p < 0.001 as compared with septum; {dagger}p < 0.030 as compared with septum; {ddagger}p < 0.001 as compared with lateral wall; §p = 0.535 as compared with lateral wall. (C) *p < 0.001 compared with RBBB-heart failure. Ant. = anterior; CURE = circumferential uniformity ratio estimate; Lat. = lateral; Post. = posterior; Sept. = septal; other abbreviations as in Figure 1.

 

Figure 3
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  		Figure 3 Functional and Mechanical Response to Various Modes of CRT in RBBB-HF

Effect of cardiac resynchronization therapy (CRT) in right bundle branch block (RBBB) + heart failure (HF) for all pacing combinations expressed as a percent change from right-atrial-paced baseline. *p < 0.007 compared with baseline; {dagger}p < 0.047 compared with baseline; {ddagger}p < 0.005 compared with left ventricular (LV)-only pacing; §p = 0.015 compared with LV-only pacing. BiV = biventricular; CURE = circumferential uniformity ratio estimate; dP/dtmax = maximum time derivative of left ventricular pressure; RV = right ventricular.

 
 
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