Document Detail


Mechanical dyssynchrony after myocardial infarction in patients with left ventricular dysfunction, heart failure, or both.
MedLine Citation:
PMID:  20176989     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Mechanical dyssynchrony is considered an independent predictor for adverse cardiovascular outcomes in patients with heart failure. However, its importance as a risk factor after myocardial infarction is not well defined. METHODS AND RESULTS: We examined the influence of mechanical dyssynchrony on outcome in patients with left ventricular dysfunction, heart failure, or both after myocardial infarction who were enrolled in the Valsartan in Acute Myocardial Infarction (VALIANT) echocardiography study. B-mode speckle tracking with velocity vector imaging was used to assess ventricular synchrony in 381 patients who had image quality sufficient for analysis. Time to regional peak velocity and time to strain rate were measured among 12 left ventricular segments from the apical 4- and 2- chamber views, and the SDs between all 12 segments were used as a measure of dyssynchrony. The relationships between the SD of time to regional peak velocity and strain rate and clinical outcome of death or heart failure were assessed. In a multivariate Cox model adjusted for clinical and echocardiographic variables, the SD of time to peak velocity (hazard ratio per 10 ms, 1.10; 95% confidence interval, 1.02 to 1.18; P=0.010) and the SD of time to strain rate (hazard ratio per 10 ms, 1.16; 95% confidence interval, 1.06 to 1.27; P=0.001) were independent predictors of death or heart failure. CONCLUSIONS: Left ventricular dyssynchrony is independently associated with increased risk of death or heart failure after myocardial infarction, suggesting that contractile pattern may play a role in post-myocardial infarction prognosis.
Authors:
Sung-Hee Shin; Chung-Lieh Hung; Hajime Uno; Amira H Hassanein; Anil Verma; Mikhail Bourgoun; Lars K?ber; Jalal K Ghali; Eric J Velazquez; Robert M Califf; Marc A Pfeffer; Scott D Solomon;
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2010-02-22
Journal Detail:
Title:  Circulation     Volume:  121     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-09     Completed Date:  2010-03-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1096-103     Citation Subset:  AIM; IM    
Affiliation:
Cardiovascular Division, Brigham and Women's Hospital, Boston, MA 02115, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Analog-Digital Conversion
Angiotensin II Type 1 Receptor Blockers / therapeutic use
Death
Disease Progression
Female
Follow-Up Studies
Heart Failure / drug therapy,  etiology,  mortality,  physiopathology,  ultrasonography*
Humans
Male
Middle Aged
Motion
Myocardial Contraction*
Myocardial Infarction / complications*
Prognosis
Proportional Hazards Models
Stress, Mechanical
Tetrazoles / therapeutic use
Valine / analogs & derivatives,  therapeutic use
Ventricular Dysfunction, Left / drug therapy,  etiology,  mortality,  physiopathology,  ultrasonography*
Video Recording
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Tetrazoles; 137862-53-4/valsartan; 7004-03-7/Valine

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


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