Systolic and diastolic dyssynchrony are unaffected by revascularization of viable, dysfunctional myocardium.
BACKGROUND
There is little information about change in dyssynchrony with stress or after revascularization.


METHODS
Subjects were recruited to this study if they were referred for revascularization of viable, dysfunctional myocardium. The inclusion criteria were ejection fraction of < or = 35%, sinus rhythm, and QRS duration < or = 120 msec. Tissue Doppler echocardiography with dobutamine stress was performed at baseline and 6 months after revascularization, and dyssynchrony indices (T-sd(c)) were calculated.


RESULTS
A total of 25 patients completed a 6-month follow-up. The mean (standard deviation) resting systolic and diastolic T-sd(c) at baseline were 49.3 (18.2) msec and 41.0 (29.4) msec, respectively, with little change during dobutamine stress. After revascularization, there were no significant differences in mean T-sd(c) although there was a modest effect on systolic T-sd(c) at recovery (46.0 [23.1] msec baseline, 34.2 [20.1] msec follow-up, mean difference 11.8 msec, 95% confidence interval 0.3-23.4 msec, P = .046).


CONCLUSIONS
Resting dyssynchrony in ischemic left ventricular dysfunction does not seem to be altered by dobutamine stress or revascularization.
Khan
Sadia N
SN
Department of Cardiology, Addenbrooke's Hospital, Hills Road, Cambridge, United Kingdom.
Sharples
Linda D
LD
Heck
Patrick M
PM
Hoole
Stephen P
SP
Dutka
David P
DP
D000368:Aged; D004280:Dobutamine; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D009204:Myocardial Revascularization; D016896:Treatment Outcome; D014463:Ultrasonography; D014665:Vasodilator Agents; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000517:prevention & control*
D014665:Vasodilator Agents; D004280:Dobutamine