Left ventricular electromechanical delay in patients with heart failure and normal QRS duration and in patients with right and left bundle branch block

被引:33
|
作者
Badano, Luigi P.
Gaddi, Oscar
Peraldo, Carlo
Lupi, Gabriele
Sitges, Marta
Parthenakis, Frangisko
Molteni, Santo
Pagliuca, Maria Rosaria
Sassone, Biagio
Di Stefano, Paola
De Santo, Tiziana
Menozzi, Carlo
Brignole, Michele
机构
[1] AO Santa Maria Misericordia, Cardiol Unit, Echo Lab, Dept Cardiopulm Sci, I-33100 Udine, Italy
[2] Osped S Maria Nuova, Dept Cardiol, Reggio Emilia, Italy
[3] Osped S Giovanni Calibita Fatebenefratelli, Dept Cardiol, Rome, Italy
[4] Osped Tigullio, Dept Cardiol, Lavagna, Italy
[5] Hosp Clin Barcelona, Dept Cardiol, Barcelona, Spain
[6] St Anna Hosp, Dept Cardiol, Como, Italy
[7] Osped S Giuseppe Moscati, Dept Cardiol, Avellino, Italy
来源
EUROPACE | 2007年 / 9卷 / 01期
关键词
bundle branch block; heart failure; echocardiography; electromechanical synchronicity; left ventricular dyssynchrony; tissue Doppler imaging;
D O I
10.1093/europace/eul144
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims We sought to define the reference values of intra-left ventricular (LV) electromechanical delay (EMD), and to assess the prevalence (and pattern) of intra-LV dyssynchrony in patients with heart failure (HF) and normal QRS and in patients with right and left bundle branch block. Methods and results We used tissue Doppler imaging echocardiography and a six-LV watt model to study LV EMD in 103 patients [41 with HF and normal QRS, 22 with right bundle branch block (RBBB), and 40 with left bundle branch block (LBBB)], and in 59 controls. In controls, the median intra-LV EMD was 17 ms, (inter-quartile range 13-30); 95% of controls had a value <= 41 ms. Patients showed a longer intra-LV EMD than controls: 33 ms (20-57) in patients with normal QRS, 32 ms (23-50) in RBBB patients, and 50 ms (30-94) in LBBB patients. Intra-LV dyssynchrony (defined as intra-LV EMD > 41 ms) was present in 39, 36, and 60% of the patients, respectively. On average, HF patients showed the same pattern of activation as controls, from the septum to the posterior watt, but activation times were significantly prolonged. In RBBB patients the activation sequence was directed from inferior to anterior and in LBBB from anterior to inferior watt. Conclusions Left ventricular dyssynchrony was present in several patients with HF and normal QRS, and in patients with RBBB; conversely, 40% of LBBB patients showed values of LV EMD within the normal range. Left ventricular activation sequence was different between groups. Assessment of LV synchronicity by means of imaging techniques may be more important than QRS duration or morphology in selecting patients for cardiac resynchronization treatment.
引用
收藏
页码:41 / 47
页数:7
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