title: Prevalence of mechanical dyssynchrony in patients with heart failure and preserved left ventricular function (a report from the Belgian Multicenter Registry on dyssynchrony).
abstract: The present study evaluated the prevalence of mechanical inter- and intraventricular dyssynchrony in patients with heart failure and preserved left ventricular (LV) ejection fraction (LVEF). We studied 138 patients with heart failure (age 67+/-11 years; 76% men); 60 patients had preserved LVEF (>40%). Using conventional Doppler echocardiography, an interventricular mechanical delay>or=40 ms was defined as interventricular dyssynchrony. Using pulse-wave tissue Doppler imaging, the time from the beginning of the QRS complex to onset of systolic motion was measured in 4 basal LV segments. A dispersion of >or=60 ms was defined as intraventricular dyssynchrony. The prevalence of inter- and intraventricular dyssynchrony was lower in patients with preserved LVEF than in those with reduced LVEF (17% vs 41%, p<0.01 for interventricular dyssynchrony, 18% vs 36%, p<0.01 for intraventricular dyssynchrony). However, patients with preserved LVEF and a QRS width>or=120 ms had higher values for the parameters for inter- and intraventricular dyssynchrony than patients with a QRS width<120 ms (interventricular mechanical delay 33+/-20 vs 20+/-16 ms, p<0.05; tissue Doppler imaging dispersion 42+/-26 vs 33+/-22 ms, p<0.05). In patients with a QRS width>or=120 ms, the prevalence of inter- and intraventricular dyssynchrony was comparable for patients with preserved and reduced LVEF (42% vs 55%, p=NS for interventricular dyssynchrony and 45% vs 46%, p=NS for intraventricular dyssynchrony). In conclusion, the prevalence of inter- and intraventricular dyssynchrony was low (17% and 18%, respectively) in patients with heart failure and preserved LVEF. However, in the presence of a QRS width of >or=120 ms, this prevalence increased to almost 50%, comparable to that for patients with heart failure and reduced LVEF and a QRS width of >or=120 ms.
authors.affiliation: Department of Cardiovascular Diseases, Ghent University, Gent, Belgium. johan.desutter@Ugent.be
authors.forename: Johan
authors.initials: J
authors.lastname: De Sutter
authors.forename: Nico R
authors.initials: NR
authors.lastname: Van de Veire
authors.forename: Luc
authors.initials: L
authors.lastname: Muyldermans
authors.forename: Tine
authors.initials: T
authors.lastname: De Backer
authors.forename: Etienne
authors.initials: E
authors.lastname: Hoffer
authors.forename: Marc
authors.initials: M
authors.lastname: Vaerenberg
authors.forename: Bernard
authors.initials: B
authors.lastname: Paelinck
authors.forename: Pierre
authors.initials: P
authors.lastname: Decoodt
authors.forename: Laurence
authors.initials: L
authors.lastname: Gabriel
authors.forename: Thierry C
authors.initials: TC
authors.lastname: Gillebert
authors.forename: Guy
authors.initials: G
authors.lastname: Van Camp
mesh_terms: D000368:Aged; D018450:Disease Progression; D018619:Echocardiography, Doppler, Pulsed; D004562:Electrocardiography; D005260:Female; D006327:Heart Block / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D006333:Heart Failure / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology*