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Relation between QRS Duration and Atrial Synchronicity in Patients with Systolic Heart Failure
Author(s) -
Turak Osman,
Özcan Fırat,
Canpolat Uğur,
Başar Fatma Nurcan,
Işleyen Ahmet,
Sökmen Erdoğan,
Tüfekçioğlu Omaç,
Çağli Kumral,
Aydoğdu Sinan
Publication year - 2014
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.12504
Subject(s) - cardiology , medicine , qrs complex , ventricular dyssynchrony , heart failure , atrium (architecture) , atrial fibrillation , cardiac resynchronization therapy , ejection fraction
Objectives The association of QRS duration ( QRS d) with ventricular dyssynchrony is well‐known in systolic heart failure ( HF ). However, there are no data regarding the relationship between QRS d and atrial dyssynchrony in patients with HF . We aimed to investigate the association of QRS d with intra‐atrial and inter‐atrial dyssynchrony in patients with systolic HF by using color tissue Doppler imaging ( TDI ). Methods The study consisted of 70 systolic HF patients and 35 healthy controls. According to QRS d, HF patients were categorized into 2 subgroups as narrow QRS (n = 35) and wide QRS (n = 35) groups. Time intervals between the onset of P‐wave and the onset of A‐wave on color TDI from the right atrium ( P‐RA ), inter‐atrial septum (P‐ IAS ) and left atrium (P‐ LA ) were measured. Atrial dyssynchrony was defined as differences between P‐ RA and P‐ IAS ( RA dyssynchrony), between P‐ LA and P‐ IAS ( LA dyssynchrony) and between P‐ RA and P‐ LA (inter‐atrial dyssynchrony). Results In patients with either HF groups, we observed significant impairment in intra‐atrial and inter‐atrial synchronicity compared with the controls (P < 0.001). Moreover, LA , RA and inter‐atrial synchrony were found to be significantly impaired in the wide QRS group compared to narrow QRS group. There was also a positive and strong correlation between atrial and ventricular dyssynchrony parameters. In stepwise multivariate analysis, QRS d was found to be the independent predictor of intra‐atrial and inter‐atrial dyssynchrony in systolic HF . Conclusion Among patients with systolic HF , prolonged QRS d is associated with impaired intra‐atrial and inter‐atrial synchrony. Atrial and ventricular dyssynchrony parameters were well‐correlated with each other.