{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T03:09:09Z","timestamp":1786417749028,"version":"build-2736575974"},"reference-count":24,"publisher":"American Physiological Society","issue":"4","funder":[{"DOI":"10.13039\/501100006095","name":"South-Eastern Norway Regional Health Authority","doi-asserted-by":"crossref","award":["2014068"],"award-info":[{"award-number":["2014068"]}],"id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100006095","name":"South-Eastern Norway Regional Health Authority","doi-asserted-by":"crossref","award":["2014076"],"award-info":[{"award-number":["2014076"]}],"id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100006095","name":"South-Eastern Norway Regional Health Authority","doi-asserted-by":"crossref","award":["2015010"],"award-info":[{"award-number":["2015010"]}],"id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100006095","name":"South-Eastern Norway Regional Health Authority","doi-asserted-by":"crossref","award":["2014069"],"award-info":[{"award-number":["2014069"]}],"id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100006095","name":"South-Eastern Norway Regional Health Authority","doi-asserted-by":"crossref","award":["2015010"],"award-info":[{"award-number":["2015010"]}],"id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100013263","name":"Norwegian Health Association","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100013263","id-type":"DOI","asserted-by":"crossref"}]},{"name":"K.G.Jebsen Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Applied Physiology"],"published-print":{"date-parts":[[2020,4,1]]},"abstract":"<jats:p> We investigated whether tachycardia in left bundle branch block (LBBB) decreases left ventricular (LV) diastolic distensibility and increases diastolic pressures due to incomplete relaxation, and if cardiac resynchronization therapy (CRT) modifies this response. Thirteen canines were studied at baseline heart rate (120 beats\/min) and atrial paced tachycardia (180 beats\/min) before and after induction of LBBB and during CRT. LV and left atrial pressures (LAP) were measured by micromanometers and dimensions by sonomicrometry. The time constant \u03c4 of exponential pressure decay and degree of incomplete relaxation at mitral valve opening (MVO) and end diastole (ED) based on extrapolation of the exponential decay were assessed. Changes in LV diastolic distensibility were investigated using the LV transmural pressure-volume (PV) relation. LBBB caused prolongation of \u03c4 ( P &lt; 0.03) and increased the degree of incomplete relaxation during tachycardia at MVO ( P &lt; 0.001) and ED ( P = 0.08) compared with normal electrical activation. This was associated with decreased diastolic distensibility seen as upward shift of the PV relation at MVO by 18.4\u2009\u00b1\u20097.0 versus 12.0\u2009\u00b1\u20095.0 mmHg, at ED by 9.8\u2009\u00b1\u20092.3 versus 4.7\u2009\u00b1\u20092.3 mmHg, and increased mean LAP to 11.4\u2009\u00b1\u20092.7 versus 8.5\u2009\u00b1\u20092.6 mmHg, all P &lt; 0.006. CRT shifted the LV diastolic PV relation downwards during tachycardia, reducing LAP and LV diastolic pressures ( P &lt; 0.03). Tachycardia in LBBB reduced LV diastolic distensibility and increased LV diastolic pressures due to incomplete relaxation, whereas CRT normalized these effects. Clinical studies are needed to determine whether a similar mechanism contributes to dyspnea and exercise intolerance in LBBB and if effects of CRT are heart rate dependent. <\/jats:p><jats:p> NEW &amp; NOTEWORTHY Compared with normal electrical conduction, tachycardia in left bundle branch block resulted in incomplete relaxation during filling, particularly of the late activated left ventricular lateral wall. This further resulted in reduced left ventricular diastolic distensibility and elevated diastolic pressures and thus amplified the benefits of cardiac resynchronization therapy in this setting. <\/jats:p>","DOI":"10.1152\/japplphysiol.01002.2018","type":"journal-article","created":{"date-parts":[[2020,1,30]],"date-time":"2020-01-30T18:58:01Z","timestamp":1580410681000},"page":"729-738","source":"Crossref","is-referenced-by-count":12,"title":["Left bundle branch block increases left ventricular diastolic pressure during tachycardia due to incomplete relaxation"],"prefix":"10.1152","volume":"128","author":[{"given":"\u00d8yvind S.","family":"Andersen","sequence":"first","affiliation":[{"name":"Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway"},{"name":"Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway"},{"name":"Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Oslo, Norway"},{"name":"Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus R.","family":"Krogh","sequence":"additional","affiliation":[{"name":"Intervention Center, Oslo University Hospital, Rikshospitalet, Oslo, Norway"},{"name":"Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Espen","family":"Boe","sequence":"additional","affiliation":[{"name":"Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway"},{"name":"Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petter","family":"Storsten","sequence":"additional","affiliation":[{"name":"Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway"},{"name":"Center for 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Medicine, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helge","family":"Skulstad","sequence":"additional","affiliation":[{"name":"Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway"},{"name":"Intervention Center, Oslo University Hospital, Rikshospitalet, Oslo, Norway"},{"name":"Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway"},{"name":"Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Oslo, Norway"},{"name":"Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans H.","family":"Odland","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway"},{"name":"Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Oslo, Norway"},{"name":"Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otto A.","family":"Smiseth","sequence":"additional","affiliation":[{"name":"Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway"},{"name":"Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway"},{"name":"Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Espen W.","family":"Remme","sequence":"additional","affiliation":[{"name":"Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway"},{"name":"Intervention Center, Oslo University Hospital, Rikshospitalet, Oslo, Norway"},{"name":"Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway"},{"name":"Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Oslo, 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