title: Changes in left ventricular synchrony and systolic function in dilated cardiomyopathy patients with fragmented QRS complexes.
abstract: OBJECTIVE
  Fragmented QRS (f-QRS) complexes are associated with adverse cardiovascular events in patients with coronary heart disease; however, the effects on patients with dilated cardiomyopathy (DCM) remain elusive. This study is to investigate the changes of left ventricular (LV) synchrony and systolic function in DCM patients with f-QRS complexes.
  
  
  RESULTS
  Twenty DCM patients with f-QRS complexes and 29 DCM patients without f-QRS (n-QRS) complexes were enrolled. The LV segmental longitudinal, radial and circumferential time to peak strain and general longitudinal systolic strain, radial strain, circumferential strain were measured, respectively, by speckle tracking imaging. The LV segmental standard deviations and maximal differences were also calculated. The LV dyssynchrony was defined as the time in peak anteroseptal wall to posterior wall strain >130 ms or longitudinal strain delay index >25%. The mean QRS durations in f-QRS and n-QRS groups were not different (P = ns). The incidence of LV dyssynchrony was 15/20 (75%) vs. 5/29 (17%) in two groups (P < 0.01). Two patients died of sudden death in f-QRS group during 2 years follow-up; however, no death in n-QRS group (P < 0.05). Patients in f-QRS group showed worsening LV dyssynchrony in f-QRS group after 2 years follow-up (P < 0.05). Overall, LV function was comparable at baseline (P = ns), but had significantly worsened only in the f-QRS group (P < 0.05).
  
  
  CONCLUSIONS
  The f-QRS complex is significantly associated with LV dyssynchrony in DCM patients and can be used as a reliable index to evaluate ventricular synchrony and predict the prognosis in DCM patients with narrow QRS complexes.
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, PR China.
authors.forename: Ling
authors.initials: L
authors.lastname: Zhao
authors.affiliation: Department of Cardiology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, PR China.
authors.forename: Juan
authors.initials: J
authors.lastname: Lu
authors.affiliation: Department of Cardiology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, PR China.
authors.forename: Zhi-Min
authors.initials: ZM
authors.lastname: Cui
authors.affiliation: Division of Cardiovascular Diseases, Thomas Jefferson University Hospital, Philadelphia, USA.
authors.forename: Behzad B
authors.initials: BB
authors.lastname: Pavri
authors.affiliation: Department of Cardiology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, PR China.
authors.forename: Min
authors.initials: M
authors.lastname: Dai
authors.affiliation: Department of Cardiology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, PR China.
authors.forename: Da-Jun
authors.initials: DJ
authors.lastname: Qian
authors.affiliation: Department of Cardiology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, PR China.
authors.forename: Wei-Gang
authors.initials: WG
authors.lastname: Shen
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, PR China.
authors.forename: Tao
authors.initials: T
authors.lastname: Guo
authors.affiliation: Department of Cardiology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, PR China ruxingw@aliyun.com.
authors.forename: Ru-Xing
authors.initials: RX
authors.lastname: Wang
mesh_terms: D000200:Action Potentials; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D002311:Cardiomyopathy, Dilated / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D016022:Case-Control Studies; D016757:Death, Sudden, Cardiac / Q000209:etiology; D018618:Echocardiography, Doppler, Color; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013599:Systole; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D016277:Ventricular Function, Left
keywords: Dilated cardiomyopathy; Fragmented QRS complex; Speckle tracking imaging; Ventricular dyssynchrony