Association between right ventricular systolic function and electromechanical delay in patients with right bundle branch block

Park, Dong Hyun; Cho, Kyoung Im; Kim, Yoon Kyung; Kim, Bong Joon; You, Ga In; Im, Sung Il; Kim, Hyun Su; Heo, Jeong

doi:10.1016/j.jjcc.2017.01.004

Cited by 11 publications

(5 citation statements)

References 23 publications

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“…Furthermore, it has been demonstrated that ECG parameters of right ventricular conduction delay correlate with echocardiographic parameters of right ventricular systolic function. 13 In this cohort of patients with Eisenmenger syndrome, we demonstrated a significant correlation between the presence of right bundle branch block and SCD (2.4-fold increased risk; P=0.01). Mechanistically, right ventricular pressure or volume overload places strain on the right bundle and the associated Purkinje network, which travel subendocardially on the right ventricular septum; therefore, the presence of a right bundle branch block can herald right ventricular strain and subsequently contribute to further worsening of the right ventricular systolic function by altered hemodynamics, dyssynchrony, delayed opening of the pulmonary valve, and inefficient right ventricular emptying.…”

Section: Discussionmentioning

confidence: 57%

“…Mechanistically, right ventricular pressure or volume overload places strain on the right bundle and the associated Purkinje network, which travel subendocardially on the right ventricular septum; therefore, the presence of a right bundle branch block can herald right ventricular strain and subsequently contribute to further worsening of the right ventricular systolic function by altered hemodynamics, dyssynchrony, delayed opening of the pulmonary valve, and inefficient right ventricular emptying. 13 Prolongation of the QRS interval was significantly associated with mortality, both sudden death and cardiac mortality. Furthermore, a QRS interval ≥120 ms predicted a 2.34-fold increased risk of SCD (P=0.009).…”

Section: Discussionmentioning

confidence: 99%

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Determinants of Sudden Cardiac Death in Adult Patients With Eisenmenger Syndrome

Chiriac

Russell

Moore

et al. 2019

Journal of the American College of Cardiology

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Determinants of Sudden Cardiac Death in Adult Patients With Eisenmenger Syndrome

Chiriac

Russell

Moore

et al. 2019

Journal of the American College of Cardiology

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“…However, RS time prolongation was significantly associated with RV dysfunction. In addition to the prominence of superiorly and rightward-oriented late vectors in RV dysfunction, RV strain due to RV dysfunction may have caused a conduction delay in the ECG and altered the QRS complexes through structural changes in the myocardium [25, 26].…”

Section: Discussionmentioning

confidence: 99%

Association between RS Time in Electrocardiogram and Right Ventricular Functions in Patients with Chronic Obstructive Pulmonary Disease

Yıldız¹,

Yildiz²,

Sazlidere³

et al. 2022

Med Princ Pract

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Objective: The occurrence of right ventricular (RV) dysfunction in chronic obstructive pulmonary disease (COPD) results in an increased risk of mortality. We aimed to study the diagnostic value of RS time in the recognition of COPD patients with RV dysfunction. Methods: 120 consecutive COPD patients were divided into two groups, patients with and without RV dysfunction, and compared them in terms of parameters including RS time. RS time was defined as the longest interval from the beginning of the QRS complex to the nadir of the S- or S′-wave in the inferolateral leads on an electrocardiogram. Results: RV dysfunction was observed in 36% of consecutive COPD patients with a mean age of 63.4 ± 9.8 years (83.3% male) and a mean forced expiratory volume in 1 s of 1.51 ± 0.62 lt. The heart rate, right QRS axis deviation frequency, S1S2S3 pattern frequency, and RS time (p < 0.01) were significantly higher in the patients with RV dysfunction than in those without. Body surface area, heart rate, and RS time (p < 0.001) were independent predictors of an RV dysfunction. An ROC analysis showed that the best RS time cutoff value for the prediction of RV dysfunction was 60 ms with a sensitivity of 81.4% and a specificity of 74.0%. Conclusion: In patients with COPD, RS time prolongation, which can be easily and quickly determined from the electrocardiogram, may be a marker for RV dysfunction.

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“…An increment in right ventricular afterload and strain is anticipated as a result of an increase in the resistance of pulmonary vasculature due to hypoxia. The right ventricular strain may cause a conduction delay in ECG and may also change the QRS complexes through structural alterations in the myocardium 22,27 . Logically, RS time tends to increase as the anatomical and functional abnormalities of the right ventricle become more prominent as the pulmonary function becomes more impaired.…”

Section: Discussionmentioning

confidence: 99%

Relationship between RS time and the severity of chronic obstructive pulmonary disease

Yıldız

Yildiz

Sazlidere

et al. 2021

Cukurova Medical Journal

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ÖzPurpose: The aim of our study was to determine whether the RS time measured on an electrocardiogram is associated with the severity of chronic obstructive pulmonary disease (COPD). Materials and Methods: The study population was made up of 100 COPD patients with a mean age of 63 ± 10 years (86% were males). These patients were divided into the mild and moderate COPD (GOLD 1-2) group (n = 45) and the severe and very severe COPD (GOLD 3-4) group (n = 55) according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages. These groups were compared with each other. Results: Heart rate, P wave axis, QRS axis, RS time, and incidence of right bundle branch block were significantly higher in patients with severe and very severe COPD. In the multivariable analysis, heart rate, P wave axis, and RS time (odds ratio = 1.081) were the independent predictors of severe and very severe COPD. The receiver operating characteristic curve analysis showed that the best RS time cutoff value for the prediction of severe and very severe COPD was 60 ms, with a sensitivity of 69.1% and a specificity of 66.7%. Conclusion: RS time simply measured on an electrocardiogram may be a useful screening test for the quick estimation of patients with severe and very severe COPD. Amaç: Çalışmamızın amacı, elektrokardiyogramdan ölçülen RS zamanının kronik obstrüktif akciğer hastalığı (KOAH) şiddeti ile ilişkili olup olmadığını belirlemekti. Gereç ve Yöntem: Çalışma popülasyonu, ortalama yaşı 63 ± 10 yıl olan (% 86 erkekti) 100 KOAH hastasından oluştu. Kronik Obstrüktif Akciğer Hastalığına Karşı Küresel Girişim (GOLD) aşamalarına göre bu hastalar hafif ve orta derecede KOAH (GOLD 1-2) grubu (s = 45) ve şiddetli ve çok şiddetli KOAH (GOLD 3-4) grubuna (s = 55) ayrıldı. Bu gruplar birbirleriyle karşılaştırıldı. Bulgular: Şiddetli ve çok şiddetli KOAH'lı hastalarda kalp hızı, P dalga aksı, QRS ekseni, RS zamanı ve sağ dal bloğu insidansı anlamlı olarak daha yüksekti. Çok değişkenli analizde, kalp hızı, P dalga aksı ve RS zamanı (olasılık oranı = 1.081) şiddetli ve çok şiddetli KOAH'ın bağımsız belirleyicileriydi. Alıcı işletim karakteristik eğrisi analizi, şiddetli ve çok şiddetli KOAH tahmini için en iyi RS zaman kesme değerinin, % 69,1 duyarlılık ve % 66,7 özgüllük ile 60 ms olduğunu gösterdi. Sonuç: Bir elektrokardiyogramda basitçe ölçülen RS zamanı, şiddetli ve çok şiddetli KOAH'lı hastaların hızlı tahmini için yararlı bir tarama testi olabilir.

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Association between right ventricular systolic function and electromechanical delay in patients with right bundle branch block

Abstract: Prolonged R' wave duration in lead V1 is an indicator of RV dysfunction and pressure and/or volume overload in patients with RBBB.

Cited by 11 publications

References 23 publications

Determinants of Sudden Cardiac Death in Adult Patients With Eisenmenger Syndrome

Determinants of Sudden Cardiac Death in Adult Patients With Eisenmenger Syndrome

Association between RS Time in Electrocardiogram and Right Ventricular Functions in Patients with Chronic Obstructive Pulmonary Disease

Relationship between RS time and the severity of chronic obstructive pulmonary disease

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