Document Detail


Left ventricular electromechanical delay in patients with heart failure and normal QRS duration and in patients with right and left bundle branch block.
MedLine Citation:
PMID:  17224421     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 wall 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 < or =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 wall, 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 wall. 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.
Authors:
Luigi P Badano; Oscar Gaddi; Carlo Peraldo; Gabriele Lupi; Marta Sitges; Frangisko Parthenakis; Santo Molteni; Maria Rosaria Pagliuca; Biagio Sassone; Paola Di Stefano; Tiziana De Santo; Carlo Menozzi; Michele Brignole
Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  9     ISSN:  1099-5129     ISO Abbreviation:  Europace     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-16     Completed Date:  2007-03-15     Revised Date:  2007-07-31    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  41-7     Citation Subset:  IM    
Affiliation:
Cardiology Unit, Echo-lab, Department of Cardiopulmonary Sciences, A.O. Santa Maria della Misericordia, Piazzale S. Maria della Misericordia 15, 33100 Udine, Italy. lbadan@tin.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Bundle-Branch Block / physiopathology*
Cardiac Output, Low / physiopathology*
Case-Control Studies
Echocardiography, Doppler
Electrocardiography*
Female
Heart Conduction System / physiopathology
Humans
Male
Middle Aged
Pilot Projects
Prospective Studies
Reference Values
Ventricular Dysfunction, Left / physiopathology*
Comments/Corrections
Erratum In:
Europace. 2007 Jun;9(6):447

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


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