Document Detail


Papillary muscle dyssynchrony as a cause of functional mitral regurgitation in non-ischemic dilated cardiomyopathy patients with narrow QRS complexes.
MedLine Citation:
PMID:  19520653     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Mitral regurgitation (MR) increases mortality in dilated cardiomyopathy (DCM). We investigated the prevalence of functional MR in non-ischemic DCM patients with narrow QRS intervals and its association with papillary muscle dyssynchrony. METHODS: Ninety-three patients were enrolled consecutively in this cross-sectional study. Patients were evaluated for the presence of intraventricular (DYS Sep-Lat Sys) and papillary muscle (DYS Inter PAP Sys) systolic dyssynchrony using tissue Doppler echocardiographic imaging (TDI). Two-dimensional and Doppler echocardiography were used for quantification of MR. Statistical analyses were performed using unpaired t test, Mann-Whitney U test, correlation and logistic regression analyses. RESULTS: Thirty-seven patients (39%) had significant DYS Sep-Lat Sys and 25 patients (26%) had DYS Inter PAP Sys. Patients with DYS Inter PAP Sys had lower basal septum systolic (p=0.007) and late diastolic velocities (p=0.049), greater MR volume (p=0.01), effective regurgitant orifice (ERO) (p=0.01), and E/A ratios (p=0.03) than the patients without DYS Inter PAP Sys. Fifty-five patients with narrow QRS intervals were also evaluated for DYS Inter PAP Sys. Patients with DYS Inter PAP Sys and narrow QRS had lower basal septum TDI peak systolic velocities (p=0.038), higher MR volume (p=0.03) and ERO (p=0.03). Logistic regression analysis revealed that NYHA Class III-IV (OR=6.4, 95% CI: 1.1-37.1, p=0.038) and DYS Inter PAP Sys (OR=9.5, 95% CI: 1.17-75.78, p=0.034) were the independent predictors of functional MR >20 ml. CONCLUSION: Papillary muscle systolic dyssynchrony is common and correlated with functional MR in non-ischemic DCM patients with sinus rhythm and narrow QRS. Papillary muscle systolic dyssynchrony may help predict patients who will benefit from cardiac resynchronization therapy.
Authors:
Kürşat Tigen; Tansu Karaahmet; Emre Gürel; Cihan Cevik; Mohammad Otahbachi; Selçuk Pala; Ali Cevat Tanalp; Bülent Mutlu; Yelda Başaran
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology     Volume:  9     ISSN:  1308-0032     ISO Abbreviation:  Anadolu Kardiyol Derg     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-12     Completed Date:  2009-09-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101095069     Medline TA:  Anadolu Kardiyol Derg     Country:  Turkey    
Other Details:
Languages:  eng     Pagination:  196-203     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Kartal Koşuyolu Heart and Research Hospital, Istanbul, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Adult
Arrhythmias, Cardiac / therapy
Cardiac Pacing, Artificial
Cardiomyopathy, Dilated / complications*,  therapy
Cross-Sectional Studies
Echocardiography, Doppler
Female
Heart Conduction System / physiopathology*
Humans
Logistic Models
Male
Mitral Valve Insufficiency / complications*,  therapy
Papillary Muscles / physiopathology*
Severity of Illness Index
Comments/Corrections
Comment In:
Anadolu Kardiyol Derg. 2009 Jun;9(3):204-5   [PMID:  19520654 ]

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