Impact of ventricular dyssynchrony on postexercise accommodation of systolic myocardial motion in hypertensive patients with heart failure and a normal ejection fraction

A tissue-Doppler echocardiography study

Yi Chih Wang, Chih Chieh Yu, Fu Chun Chiu, Ruth Klepfer, Kathryn Hilpisch, Vincent Splett, Chia Ti Tsai, Ling Ping Lai, Juey Jen Hwang, Jiunn Lee Lin

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: We hypothesized left ventricular (LV) dyssynchrony would affect postexercise accommodation of regional myocardial motion in patients with heart failure and a normal ejection fraction (HFNEF). Methods and Results: Tissue-Doppler echocardiography was studied in 100 hypertensive patients with LV ejection fraction >50%. Among them, 70 HFNEF patients were classified into the systolic dyssynchrony (Dys: >65 ms difference of electromechanical delay between septal and lateral segments) (43 patients) and nondyssynchrony (Ndys: 27 patients) groups, and the other 30 patients were as the control (Ctrl). The systolic myocardial velocities (Sm) of 6-basal LV segments at baseline and after exercise were analyzed. When compared with the Ctrl group, the baseline lower mean Sm of 6 LV segments in the Ndys group could increase to a similar postexercise level as that in the Ctrl group, whereas that in the Dys group remained lower after exercise (7.8 ± 1.3 versus Ndys: 8.6 ± 1.5 and Ctrl: 8.9 ± 1.2 cm/s, P <.05, respectively). This is mainly due to a much higher percentage increase of lateral Sm after exercise in the Ndys group (Ndys: 49 versus Dys: 29%, P <.05). Conclusions: Dyssynchrony-related regional myocardial contractile abnormality after exercise in HFNEF patients suggested the detrimental impact of electromechanical uncoupling on HF symptoms.

Original languageEnglish
Pages (from-to)134-139
Number of pages6
JournalJournal of Cardiac Failure
Volume18
Issue number2
DOIs
Publication statusPublished - Feb 1 2012
Externally publishedYes

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Doppler Echocardiography
Heart Failure
Exercise
Control Groups
Stroke Volume

Keywords

  • dyssynchrony
  • exercise
  • Heart failure with a normal ejection fraction
  • myocardial contraction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Impact of ventricular dyssynchrony on postexercise accommodation of systolic myocardial motion in hypertensive patients with heart failure and a normal ejection fraction : A tissue-Doppler echocardiography study. / Wang, Yi Chih; Yu, Chih Chieh; Chiu, Fu Chun; Klepfer, Ruth; Hilpisch, Kathryn; Splett, Vincent; Tsai, Chia Ti; Lai, Ling Ping; Hwang, Juey Jen; Lin, Jiunn Lee.

In: Journal of Cardiac Failure, Vol. 18, No. 2, 01.02.2012, p. 134-139.

Research output: Contribution to journalArticle

Wang, Yi Chih ; Yu, Chih Chieh ; Chiu, Fu Chun ; Klepfer, Ruth ; Hilpisch, Kathryn ; Splett, Vincent ; Tsai, Chia Ti ; Lai, Ling Ping ; Hwang, Juey Jen ; Lin, Jiunn Lee. / Impact of ventricular dyssynchrony on postexercise accommodation of systolic myocardial motion in hypertensive patients with heart failure and a normal ejection fraction : A tissue-Doppler echocardiography study. In: Journal of Cardiac Failure. 2012 ; Vol. 18, No. 2. pp. 134-139.
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abstract = "Background: We hypothesized left ventricular (LV) dyssynchrony would affect postexercise accommodation of regional myocardial motion in patients with heart failure and a normal ejection fraction (HFNEF). Methods and Results: Tissue-Doppler echocardiography was studied in 100 hypertensive patients with LV ejection fraction >50{\%}. Among them, 70 HFNEF patients were classified into the systolic dyssynchrony (Dys: >65 ms difference of electromechanical delay between septal and lateral segments) (43 patients) and nondyssynchrony (Ndys: 27 patients) groups, and the other 30 patients were as the control (Ctrl). The systolic myocardial velocities (Sm) of 6-basal LV segments at baseline and after exercise were analyzed. When compared with the Ctrl group, the baseline lower mean Sm of 6 LV segments in the Ndys group could increase to a similar postexercise level as that in the Ctrl group, whereas that in the Dys group remained lower after exercise (7.8 ± 1.3 versus Ndys: 8.6 ± 1.5 and Ctrl: 8.9 ± 1.2 cm/s, P <.05, respectively). This is mainly due to a much higher percentage increase of lateral Sm after exercise in the Ndys group (Ndys: 49 versus Dys: 29{\%}, P <.05). Conclusions: Dyssynchrony-related regional myocardial contractile abnormality after exercise in HFNEF patients suggested the detrimental impact of electromechanical uncoupling on HF symptoms.",
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AU - Splett, Vincent

AU - Tsai, Chia Ti

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AU - Hwang, Juey Jen

AU - Lin, Jiunn Lee

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