| The impact of exercise-induced changes in intraventricular dyssynchrony on functional improvement in patients with nonischemic cardiomyopathy. | |
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MedLine Citation:
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PMID: 18325737 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The assessment of dynamic intraventricular dyssynchrony has been reported to be feasible in a clinical setting. However, its prognostic implication in functional improvement has not yet been investigated. METHODS: Symptom-limited, supine bicycle exercise was performed on 41 patients with nonischemic cardiomyopathy (52 +/- 12 years, ejection fraction < 40%). Using Doppler tissue imaging, the average of peak systolic velocities at 6 basal segments was obtained at rest and peak exercise. Dyssynchrony index (Ts-SD12) was defined as the SD of the time to peak systolic velocities at 12 left ventricular segments. The percent change of end-systolic volume (%Delta ESV) was calculated at follow-up. A 15% or greater reduction in end-systolic volume (%Delta ESV < -15%) was considered as functional improvement. RESULTS: During exercise, changes in dyssynchrony (Delta Ts-SD12) were individually variable. Average of peak systolic velocities (V) at 6 basal segments at peak exercise independently correlated with Ts-SD12 at peak exercise (beta = -0.541, P < .001). Follow-up echocardiography was performed on 35 patients after medical treatment for 13.0 +/- 4.9 months. There was significant association of %Delta ESV with the change in mitral regurgitation (r = 0.434, P = .009), disease duration (r = 0.343, P = .045), QRS interval (r = 0.347, P = .041), and Delta Ts-SD12 (r = 0.511, P = .002). Multivariate analysis identified Ts-SD12 measured at peak exercise as the strongest predictor for functional improvement (%Delta ESV: beta = 0.577, P < .001; and Delta ejection fraction: beta = -0.563, P < .001). CONCLUSION: In patients with heart failure, dynamic dyssynchrony can be assessed during exercise. Ts-SD12 at peak exercise may be an independent predictor for reverse remodeling with medical treatment. |
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Authors:
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Soo-Jin Kang; Hong-Seok Lim; Byoung-Joo Choi; So-Yeon Choi; Myeong-Ho Yoon; Gyo-Seung Hwang; Joon-Han Shin; Seung-Jea Tahk |
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Publication Detail:
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Type: Journal Article Date: 2008-03-06 |
Journal Detail:
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Title: Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography Volume: 21 ISSN: 1097-6795 ISO Abbreviation: J Am Soc Echocardiogr Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-07-28 Completed Date: 2008-09-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8801388 Medline TA: J Am Soc Echocardiogr Country: United States |
Other Details:
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Languages: eng Pagination: 948-53 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Ajou University Hospital, Suwon, South Korea. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiomyopathies
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ultrasonography* Echocardiography, Doppler / methods* Exercise Test / methods* Female Humans Male Middle Aged Myocardial Ischemia / ultrasonography Reproducibility of Results Sensitivity and Specificity Ventricular Dysfunction, Left / ultrasonography* |
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