Provocation of Masked Left Ventricular Mechanical Dyssynchrony by Treadmill Exercise in Patients With Systolic Heart Failure and Narrow QRS Complex

Yi Chih Wang, Juey Jen Hwang, Chih Chieh Yu, Ling Ping Lai, Chia Ti Tsai, Lung Chun Lin, Rodolphe Katra, Jiunn Lee Lin

研究成果: 雜誌貢獻文章同行評審

10 引文 斯高帕斯(Scopus)

摘要

Tissue Doppler imaging-derived intra-left ventricular (LV) contractile dyssynchrony is an evolving prognostic parameter for patients with systolic heart failure (HF). However, whether and how exercise could abolish the synchronicity in HF patients with narrow QRS remains less studied. We evaluated a total of 33 HF patients with impaired LV ejection fraction (<50%), QRS duration ≤120 ms, and baseline dyssynchrony index (DI; standard deviation of electromechanical delay of 12 LV segments by tissue Doppler imaging) <33 ms. After a 6-minute treadmill exercise by modified Bruce protocol, the absolute time difference from QRS onset to peak systolic myocardial velocity of each segment was recorded immediately. With similar DI at rest and peak heart rates during exercise, 11 patients (33%) developed dyssynchrony (DI ≥33 ms) after exercise, and the others did not (44.7 ± 8.0 vs 16.2 ± 8.3 ms, p <0.001). Patients with dyssynchrony after exercise had greater baseline mitral early diastolic velocity/annular early diastolic velocity (E/Ea) (19 ± 17 vs 10 ± 5, p <0.026). Multivariate analysis revealed mitral E/Ea >10 at rest, indicating higher LV filling pressure, independently predicted the exercise-evoked dyssynchrony (odds ratio 18, 95% confidence interval 2 to 163, p <0.012). In conclusion, exercise uncovered masked LV dyssynchrony in 1/3 of systolic HF patients with narrow QRS, and exercise-provoked dyssynchrony could be predicted by mitral E/Ea >10 at rest.
原文英語
頁(從 - 到)658-661
頁數4
期刊American Journal of Cardiology
101
發行號5
DOIs
出版狀態已發佈 - 3月 1 2008
對外發佈

ASJC Scopus subject areas

  • 心臟病學與心血管醫學

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