Absence of correlation between QRS duration and echographic parameters of ventricular desynchronization. Can we still trust the electrocardiographic criteria?
The aim of the study was to assess if echographic ventricular desynchronization parameters measured in patients with dilated cardiomyopathy (DCM) and severe heart failure are correlated with the duration of the QRS on surface electrocardiogram.


METHODS
This study included 51 pts aged 58.8 +/- 7.4 years with idiopathic DCM. The following parameters were measured: QRS duration; effective contraction time (ECT) measured as the interval between QRS onset and closure of aortic valve, interventricular delay (IVD) measured as the time between onset of aortic and pulmonary flow, left ventricular mechanical delay (LVD) as the time from maximal interventricular septum contraction and posterior wall contraction, posterior (P), lateral (L) and posterolateral (PL) wall delays, as the time from QRS onset to maximal wall contraction. Regional postsystolic contraction was defined in a given wall as the difference (contraction delay - ECT)> 50ms.


RESULTS
29 pts presented complete LBBB, 22 pts had QRS duration < 120 ms. 39 pts had a postsystolic contraction of the PL wall (32 pts of the L wall and 26 pts of the P wall). 16 pts with QRS duration <120 had a postsystolic contraction of the PL wall (as for the LBBB the rest of 39 pts). In 40 pts the sequence of regional ventricular contraction was: P-L-PL wall (16 pts with QRS<120). LVD was > 100 ms in 36 pts (26 pts with LBBB and 10 with QRS<120). 27 of pts with LBBB and 6 with QRS <120 ms presented IVD> 30ms. There was no correlation between the QRS duration and the parameters listed above.


CONCLUSIONS
In DCM pts there is no correlation between the duration of the QRS and echocardiographic parameters of ventricular desynchronization. Mechanical ventricular de-synchrony can be observed in patients with QRS duration < 120 ms.
Cozma
D
D
Institute of Cardiovascular Medicine, Timişoara, Romania.
Lighezan
D
D
Petrescu
L
L
Pescariu
S
S
Luca
C T
CT
Mornoş
C
C
Gyalai
I
I
Drăgulescu
St I
SI
D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006333:Heart Failure / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction