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Color Doppler Tissue Velocity Imaging Can Disclose Systolic Left Ventricular Asynchrony Independent of the QRS Morphology in Patients with Severe Heart Failure
Author(s) -
SCHUSTER PETER,
FAERESTRAND SVEIN,
OHM OLEJØRGEN
Publication year - 2004
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 - 10.1111/j.1540-8159.2004.00464.x
Subject(s) - medicine , cardiology , left bundle branch block , cardiac resynchronization therapy , heart failure , doppler imaging , qrs complex , tissue doppler echocardiography , systole , asynchrony (computer programming) , basal (medicine) , diastole , ejection fraction , blood pressure , computer network , asynchronous communication , computer science , insulin , diastolic function
A QRS width greater than 120 ms is assumed to be a marker of inter‐ and intraventricular asynchrony in severe heart failure (HF) patients. Color Doppler tissue velocity imaging (c‐TVI) with a time resolution of 10 ms was used to study regional left ventricular (LV) longitudinal systolic contraction pattern in HF patients with left and right bundle branch block (LBBB and RBBB) and in patients with normal QRS width. We studied 12 women and 23 men with severe HF, with a mean age of 66 ± 11 years in New York Heart Association functional Class 2.9 ± 0.6. Twenty patients had LBBB and 10 of those were accepted for cardiac resynchronization therapy by biventricular pacing (CRT). Ten patients had normal QRS width, and five had RBBB. In the echocardiographic apical four chamber view, regional peak LV tissue velocities and regional LV time differences of peak tissue velocities were compared at basal and mid‐LV segments. There were no significant differences in regional mean peak tissue velocities among the patient groups. In patients with LBBB accepted for CRT, the LV lateral free‐wall movement at basal LV was 29 ms delayed during main systole, almost significantly different from LBBB patients not accepted for CRT (P = 0.075). Even in HF patients with normal QRS width or RBBB, significant asynchronous longitudinal LV contraction was observed. Conclusions: For the detection of regional longitudinal LV contraction asynchrony in patients with severe HF, supplementary methods to the surface ECG, such as c‐TVI, are strongly recommended. (PACE 2004; 27:460–467)