Implication of QRS Prolongation and Its Relation to Mechanical Dyssynchrony in Idiopathic Dilated Cardiomyopathy in Childhood

Chun An Chen, Cheng Hui Hsiao, Jou Kou Wang, Ming Tai Lin, En Ting Wu, Shuenn Nan Chiu, Hsin Hui Chiu, Mei Hwan Wu

研究成果: 雜誌貢獻文章同行評審

16 引文 斯高帕斯(Scopus)

摘要

We explored the role of QRS prolongation (≥120 ms) and its relation to mechanical dyssynchrony and outcomes in childhood idiopathic dilated cardiomyopathy (IDC). A total of 89 patients ≤18 years old diagnosed as having IDC (21 days to 26 years of follow-up) were investigated. In 20 survivors with residual left ventricular (LV) dysfunction, mechanical (interventricular and intra-LV) dyssynchrony was assessed. The SD of time from the beginning of QRS prolongation to peak systolic contraction was measured in 12 LV segments by tissue Doppler imaging. A cut-off value >32.6 ms was used to define intra-LV dyssynchrony. The 1- and 5-year survivals were 70% and 53%, respectively. Requirement of intravenous inotropes at follow-up (hazard ratio 3.10) and initial LV ejection fraction (hazard ratio 0.95) were major prognostic factors. QRS prolongation, primarily left bundle branch block, was identified in 16 patients (18%) and tended to increase the risk of requiring inotropes. Moreover, none of those with QRS prolongation regained normal cardiac function at follow-up. Two patients with QRS prolongation showed marked improvement in cardiac function after cardiac resynchronization therapy. Mechanical dyssynchrony was noted in all patients with QRS prolongation and in 8% (interventricular) or 38% (intra-LV) of those without. In conclusion, QRS prolongation was common in childhood IDC and was possibly associated with persistent LV dysfunction and worse cardiac outcome. Mechanical (inter- and intraventricular) dyssynchrony was highly prevalent in those with QRS prolongation and was still often observed in those without.

原文英語
頁(從 - 到)103-109
頁數7
期刊American Journal of Cardiology
103
發行號1
DOIs
出版狀態已發佈 - 一月 1 2009
對外發佈

ASJC Scopus subject areas

  • 心臟病學與心血管醫學

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