Heart failure & cardiomyopathiesCase-control study
Mechanical dyssynchrony and septal–lateral perfusion heterogeneity predict adverse left ventricular remodelling beyond ECG-defined left bundle branch block (LBBB)
- matched case-control analysis of PET myocardial perfusion imaging
Authors' conclusion
Mechanical dyssynchrony and perfusion heterogeneity independently predict adverse LV remodelling, irrespective of LBBB. Integrated imaging improves cardiomyopathy stratification.
Study context
- Population
- Patients with and without LBBB who underwent PET myocardial perfusion imagingLBBB patients 233 · matched controls 932
- Participants
- 233 vs 932
- Comparison
- LBBB patients compared with controls
- LBBBn = 233
- controlsn = 932
Main finding
As reported in the abstract
Dyssynchrony, LV volumes, EF
dyssynchrony
EF
Observational data: associations, not effects.
Further findings
| Outcome | LBBB | controls |
|---|---|---|
| Stress CVR, MBF, MFR, SLR | ||
| stress CVR | 37 mmHg/mL·min-1·g-1 | 34 mmHg/mL·min-1·g-1 |
| MBF | 2.4 mL/min/g | 2.6 mL/min/g |
| MFR | 2.4 | 2.6 |
| SLR | 0.95 | 1.00 |
- Stress coronary vascular resistance (CVR), myocardial blood flow (MBF), myocardial flow reserve (MFR), SLR: all P < 0.05
Remodelling among patients with dyssynchrony
- SLR <1.0 identified greater remodelling
Left ventricular (LV) volumes and ejection fraction (EF) (multivariable regression)
- phase entropy and SLR independently predicted LV volumes and EF; adverse effects of SLR reduction amplified in LBBB
- interaction P < 0.01
Death or heart failure hospitalization (Cox analysis)
- phase entropy HR
- 1.02
- phase entropy P
- P = 0.01
- MFR HR
- 0.62
- MFR P
- P < 0.001
- LVEF HR
- 0.97
- LVEF P
- P < 0.001
- LBBB was not independently associated
Original publication
Mechanical dyssynchrony and septal–lateral perfusion heterogeneity predict adverse left ventricular remodelling beyond ECG-defined LBBB. Eur Heart J Cardiovasc Imaging. Published 27 March 2026. doi:10.1093/ehjci/jeag081
Summarised from the published abstract; every number is checked against it