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Ventricular Coupling of Electrical and Mechanical Dyssynchronization in Heart Failure Patients
Author(s) -
TOUSSAINT JEANFRANÇOIS,
LAVERGNE THOMAS,
KERROU KHALDOUN,
DE DIEULEVEULT BARBARA,
PONCE FELIZARDO,
FROISSART MARC,
LE HEUZEY JEANYVES,
GUIZE LOUIS,
PAILLARD MICHEL
Publication year - 2002
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1046/j.1460-9592.2002.00178.x
Subject(s) - medicine , ejection fraction , ventricle , qrs complex , cardiology , heart failure , asynchrony (computer programming) , ventricular function , computer network , asynchronous communication , computer science
TOUSSAINT, J‐F., et al. : Ventricular Coupling of Electrical and Mechanical Dyssynchronization in Heart Failure Patients. We studied the relationships of electrical and mechanical synchronization in patients with heart failure (CHF) and various degree of ventricular conduction delays. Ninety‐two CHF patients ( 60 ± 13 years old, LVEF < 45% ), NYHA II‐III‐IV, and 35 age‐matched control subjects were studied with angioscintigraphic phase analysis. We measured ejection fractions (LVEF, RVEF) and calculated the total activation time for the left (TtLV) and right ventricle (TtRV), and the synchronization time between right and left ventricle (TRVLV), and between LV apex and base (Tab). Patients were divided into three groups according to QRS duration: group 1 < 120 ms ( n = 28 ), group 2 < 150 ms ( n = 23 ), group 3 ≥ 150 ms ( n = 41 ). In group 1: LVEF = 31.1 ± 10.9% , RVEF = 30.1 ± 12.6% , TtLV = 204 ± 70 ms , TtRV = 183 ± 61 ms , TRVLV = 7 ± 33 ms , Tab = 29 ± 23 ms . In group 2, these were: 27.8 ± 9.1% , 27.8 ± 8.8% , 227 ± 95 ms , 248 ± 137 ms , 35 ± 42 ms* , and 39 ± 53 ms respectively. In group 3: LVEF = 20.5 ± 9.5%† , RVEF = 28.4 ± 16.1% , TtLV = 304 ± 155 ms† , TtRV = 234 ± 106 ms† , TRVLV = 64 ± 42 ms† , and Tab = 67 ± 48 ms* , all P < 0.001 versus controls *P < 0.05 versus G1, †P ≤ 0.01 versus G1 . A significant relation links QRS to both inter‐ and intraventricular asynchrony (TRVLV: r = 0.65 ; TtLL: r = 0.70 , Tab: r = 0.60 ), and to LV function ( r = 0.72 ); while LVEF relates more closely to intraventricular asynchrony: TtLV ( r = 0.52 ), TtLL ( r = 0.67 ), than to interventricular asynchrony: TRVLV ( r = 0.48 ); P < 0.01 , P ≤ 0.001 . In CHF patients, electromechanical and contractile alterations are coupled; regional activation may be an early parameter allowing the detection of ventricular dyssynchronization.