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

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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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Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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