title: Left ventricular dyssynchrony in patients showing diastolic dysfunction without overt symptoms of heart failure.
abstract: OBJECTIVE
  Few studies have assessed left ventricular (LV) dyssynchrony in cases of diastolic dysfunction that do not include overt symptoms of heart failure. We hypothesized that systolic or diastolic dyssynchrony involves unique features with respect to the degree of diastolic impairment in isolated diastolic dysfunction.
  
  
  METHODS
  We examined 105 subjects with no history of overt symptoms of heart failure and a left ventricular ejection fraction > 50% for mechanical dyssynchrony using tissue Doppler imaging.
  
  
  RESULTS
  In terms of longitudinal dyssynchrony, four cases showed (6.3%) LV intraventricular systolic dyssynchrony (SDS(LV)), whereas none had LV intraventricular diastolic dyssynchrony (DDS(LV)) or co-existing systolic dyssynchrony. Radial dyssynchrony (RD) was found in six cases (9.4%). After adjusting for age, SDS(LV) and DDS(LV) were found to be significantly related to increases in the E/E' ratio (r = 0.405 and p < 0.001 vs. r = 0.216 and p = 0.045, respectively). RD at the base and apex was also significantly related to increases in E/E' (r = 0.298 and p = 0.002 vs. r = 0.196 and p = 0.045, respectively).
  
  
  CONCLUSIONS
  Systolic and diastolic dyssynchrony in subjects with isolated diastolic dysfunction but without overt symptoms of heart failure was not as common as in patients with diastolic heart failure; however, the systolic and diastolic intraventricular time delay increased with increases in the E/E' ratio, an indicator of diastolic dysfunction.
authors.affiliation: Department of Cardiology, Fatima General Hospital, Daegu, Korea.
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: Hee Sang
authors.initials: HS
authors.lastname: Jang
authors.forename: Byung Seok
authors.initials: BS
authors.lastname: Bae
authors.forename: Seung Min
authors.initials: SM
authors.lastname: Shin
authors.forename: Ki Ju
authors.initials: KJ
authors.lastname: Kim
authors.forename: Jung Gil
authors.initials: JG
authors.lastname: Park
authors.forename: Hyun Jae
authors.initials: HJ
authors.lastname: Kang
authors.forename: Bong Ryeol
authors.initials: BR
authors.lastname: Lee
authors.forename: Byung Chun
authors.initials: BC
authors.lastname: Jung
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D054144:Heart Failure, Diastolic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*