[The influence of intracardiac asynchronism on the clinical course of chronic cardiac insufficiency].
Intracardiac asynchronism presents systolic and/or diastolic dyscoordination in different myocardial areas within one and/or between different cardiac chambers. QRS complex widening is the marker of electric asynchronism. In 1/3 of patients with chronic cardiac insufficiency (CCI), the width of QRS complex is more than 120 msec. sixty-five CCI patients (56 men aged 63.7 +/- 7.3 years and 9 women aged 66.8 +/- 8.2 years) were divided into two groups: the group with a wide QRS (more than 120 msec) and the group with a narrow QRS (less than 120 msec), 30 and 35 patients, respectively. In the group with a wide QRS, 96.6% of patients suffered from clinically significant CCI (functional class III to IV); in the other group it was observed in 65.7% of patients. The patients were observed during three years. CCI dynamics was evaluated, quality of life was assessed using the Russian version of SF questionnaire, and three-year survival rate was assessed by Kaplan-Meyer method. The presence of electric asynchronism in a form of a wide QRS complex promotes CCI progression, accompanied by CCI functional class deterioration as well as clinical worsening and decreased physical exercise tolerance according to 6-min walking test. The frequency of seeking medical aid was significantly higher among patients with a wide QRS complex.
D000368:Aged; D002303:Cardiac Output, Low / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D002908:Chronic Disease; D018618:Echocardiography, Doppler, Color; D004562:Electrocardiography; D017079:Exercise Tolerance; D005260:Female; D006329:Heart Conduction System / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016138:Walking