Document Detail


Effect of intraventricular dyssynchrony on diastolic function and exercise tolerance in patients with heart failure.
MedLine Citation:
PMID:  19602490     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Intraventricular dyssynchrony may contribute to the severity of heart failure [congestive heart failure (CHF)]. We assessed the correlates of intraventricular dyssynchrony and evaluated dyssynchrony as an independent predictive variable of exercise intolerance in CHF patients. METHODS AND RESULTS: Eighty-one CHF patients (66 +/- 9 years) underwent cardiopulmonary exercise test. Left ventricular (LV) diastolic function was evaluated by transmitral patterns and tissue Doppler. Intraventricular dyssynchrony was calculated according to time intervals between the onset of QRS and the onset of systolic velocities of basal septum and lateral wall. We divided the patients based on the mean value (40 ms) of dyssynchrony. Patients with intraventricular dyssynchrony (>40 ms) showed higher New York Heart Association class (2.7 +/- 0.6 vs. 2.2 +/- 0.4, P < 0.001), higher brain natriuretic peptide (BNP) (415 +/- 478 vs. 194 +/- 205, P = 0.014), more frequent restrictive transmitral pattern (33 vs. 7%, P = 0.013), higher E/E(a) (13 +/- 7 vs. 10 +/- 6, P = 0.016), lower mitral annulus peak systolic velocity (4.5 +/- 1.1 vs. 5.5 +/- 1.5 cm/s, P = 0.01), and peak oxygen consumption (13.8 +/- 3.5 vs. 18.1 +/- 3.9, P < 0.001), than patients without dyssynchrony (< or =40 ms). Predictors of exercise tolerance were intraventricular dyssynchrony (P = 0.035), log BNP (P = 0.003), and E/E(a) (P = 0.004). CONCLUSION: Intraventricular dyssynchrony correlates with higher LV filling pressure and lower ejection fraction and it is an independent predictor of poor aerobic capacity; it may be helpful for functional evaluation of CHF patients.
Authors:
Quirino Ciampi; Bruno Petruzziello; Michele Della Porta; Salvatore Caputo; Vincenzo Manganiello; Costantino Astarita; Bruno Villari
Publication Detail:
Type:  Journal Article     Date:  2009-07-14
Journal Detail:
Title:  European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology     Volume:  10     ISSN:  1532-2114     ISO Abbreviation:  Eur J Echocardiogr     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-05     Completed Date:  2010-01-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100890618     Medline TA:  Eur J Echocardiogr     Country:  England    
Other Details:
Languages:  eng     Pagination:  907-13     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Fatebenefratelli Hospital, Viale Principe di Napoli, 12, I-82100 Benevento, Italy. qciampi@iol.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Chi-Square Distribution
Coronary Angiography
Diastole / physiology
Echocardiography, Doppler*
Exercise Test
Exercise Tolerance / physiology*
Female
Heart Failure / physiopathology*,  ultrasonography*
Humans
Linear Models
Male
Natriuretic Peptide, Brain / blood
Oxygen Consumption / physiology
Prospective Studies
Ventricular Dysfunction, Left / physiopathology*,  ultrasonography*
Chemical
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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