title: Effects of aortic valve replacement on left ventricular dyssynchrony in aortic stenosis with narrow QRS complex.
abstract: BACKGROUND
  The presence and determinants of left ventricular (LV) dyssynchrony in patients with aortic stenosis (AS) are not clear. The aims of this study were to (1) investigate the presence and determinants of LV dyssynchrony and (2) assess if LV dyssynchrony could improve after aortic valve replacement (AVR) in patients with AS with narrow QRS complexes.
  
  
  METHODS
  Twenty healthy subjects and 30 consecutive patients with AS were retrospectively studied. AVR was performed in 19 patients. The time to peak systolic velocity with reference to the QRS complex (Ts), the standard deviation of Ts (Ts-SD), and maximal difference of Ts were measured as the index of LV dyssynchrony in 12 LV segments on Doppler tissue imaging.
  
  
  RESULTS
  Ts-SD (25 ± 17 vs 52 ± 15 msec) and the maximal difference of Ts (70 ± 47 vs 148 ± 38 msec) were significantly greater (P < .001) in patients with AS than in healthy subjects. Early after AVR (11 ± 4 days), LV dyssynchrony significantly improved with the shortening of Ts-SD (29 ± 14 msec) and the maximal difference of Ts (91 ± 42 msec) (P < .001). Ts-SD was significantly correlated with estimated LV systolic pressure (r = 0.53, P < .001) and LV mass index (r = 0.28, P = .02).
  
  
  CONCLUSIONS
  LV dyssynchrony is not uncommon in patients with AS with narrow QRS complexes and is reversible early after AVR, suggesting the favorable effect of afterload reduction on dyssynchronous LV contraction.
authors: Cardiovascular Division, Osaka Minami Medical Center, Kawachinagano, Japan.
authors: Haruhiko
authors: H
authors: Abe
authors: Satoshi
authors: S
authors: Nakatani
authors: Hideaki
authors: H
authors: Kanzaki
authors: Noriaki
authors: N
authors: Iwahashi
authors: Takuya
authors: T
authors: Hasegawa
authors: Masafumi
authors: M
authors: Kitakaze
authors: Kunio
authors: K
authors: Miyatake
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control*