| Utility of QRS width and echocardiography parameters in an integrative algorithm for selecting heart failure patients with cardiac dyssynchrony. | |
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MedLine Citation:
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PMID: 19327615 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Cardiac resynchronization therapy (CRT) is an effective treatment in dilated cardiomyopathy (DCM). However, it has been demonstrated that mechanical dyssynchrony is not related to electrical dyssynchrony. We hypothesized that a new QRS width cutoff could be easier to use as a first step in the selection of patients with inter- and intraventricular dyssynchrony. METHODS: We included 58 patients with DCM. Electrocardiographic (PR interval and QRS width) and echocardiographic (left ventricular dimensions, systolic and diastolic function, dyssynchrony parameters) data were evaluated in all patients. RESULTS: According to QRS width, we divided the study population in two groups: Group 1, 25 patients having a narrow QRS (<or=120 ms), and Group 2, 33 patients having a wide QRS (>120 ms). Patients in Group 2 had larger left ventricles, with similar systolic function and more severe diastolic dysfunction than patients with narrow QRS. Interventricular dyssynchrony was more frequent in group 2 (54.5% vs 20%, p=0.01), while intraventricular dyssynchrony was highly prevalent in both groups (82.1% vs 72%, p=0.48). A QRS>140 ms best predicted the presence of interventricular dyssynchrony (sensitivity 78.2% and specificity 63.6%), while a QRS>150 ms best predicts intraventricular dyssynchrony (sensitivity 48.6% and specificity 80%). CONCLUSIONS: Intraventricular dyssynchrony has a high prevalence in patients with DCM, irrespective of the QRS width. Using a higher QRS width cutoff (150 ms) might help in patient selection for CRT. Electrocardiography and echocardiography can be combined into a selection algorithm for patients receiving resynchronization therapy. |
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Authors:
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Ruxandra Jurcut; Ioana Pop; Cosmin Calin; Ioan Mircea Coman; Radu Ciudin; Carmen Ginghina |
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Publication Detail:
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Type: Clinical Trial; Journal Article Date: 2008-09-10 |
Journal Detail:
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Title: European journal of internal medicine Volume: 20 ISSN: 1879-0828 ISO Abbreviation: Eur. J. Intern. Med. Publication Date: 2009 Mar |
Date Detail:
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Created Date: 2009-03-30 Completed Date: 2009-06-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9003220 Medline TA: Eur J Intern Med Country: Netherlands |
Other Details:
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Languages: eng Pagination: 213-20 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Institute of Cardiovascular Diseases Prof.C.C.Iliescu, 258 Fundeni Way, 022328 Bucharest, Romania. rjurcut@gmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Algorithms Cardiac Pacing, Artificial* Cardiomyopathy, Dilated / therapy*, ultrasonography* Echocardiography* Electrocardiography Female Heart Failure / therapy, ultrasonography Humans Male Middle Aged Myocardial Contraction Patient Selection* Predictive Value of Tests Sensitivity and Specificity |
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