Evaluation of Right Ventricular Systolic Function in Patients with Right Bundle Branch Block Using Two-Dimensional Speckle Tracking Echocardiography

Abstract

Background: the prevalence of right bundle branch block (RBBB) is estimated to be 0.2-2.3% in healthy individuals in many previous studies. The prevalence of RBBB increases with age, higher in men, diabetics and in patients with hypertension. Objectives: the purpose of this study was to evaluate the right ventricular systolic function in patients with right bundle branch block with structurally normal heart disease using conventional and speckle tracking 2D echocardiography. Subjects and Methods: forty patients with right bundle branch block (RBBB) were classified into 2 groups each of 20 patients; complete right bundle branch block (CRBBB) and incomplete RBBB (IRBBB), beside 20 normal individuals matched in age and sex served as controls. Results: Tricuspid annular plane systolic excursion (TAPSE) and right ventricle free wall longitudinal strain (RV FWLS) were not statistically significant in patients with RBBB, there was decrease in CRBBB than normal individuals. In right ventricle global longitudinal strain (RV GLS), tricuspid lateral annular systolic velocity (S’), Tei index by both tissue and pulsed Doppler assessment, fractional area change (RV FAC%) and RV basal diameter; and in incomplete right bundle branch block in the mean of RV STE GLS%, S’, Tei index by both tissue and pulsed Doppler. Conclusion: Isolated right bundle branch block has an effect on the RV morphologic characteristics, systolic function compared with healthy individuals by 2D, M-mode, Doppler and speckle tracking echocardiographic assessment.