Interventricular and intraventricular dyssynchrony in idiopathic dilated cardiomyopathy

Fauchier, Laurent; Marie, Olivier; Casset-Senon, Danielle; Babuty, Dominique; Cosnay, P; Fauchier, J P

doi:10.1016/s0735-1097(02)02569-x

Cited by 180 publications

(33 citation statements)

References 23 publications

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“…In our study, we decided to consider hospitalizations for unstable angina or arrhythmias as worsening HF events, as both conditions may be related to increased filling pressures that may lead to subendocardial ischemia and arrhythmias. We confirmed the data of a recent study (20) that nicely showed that the presence of intra-LV asynchrony is an independent factor of worsening HF and mortality. However, we provided further data on correlations between the QRS width and morphology with the degree and type of ventricular asynchrony.…”

Section: Discussionsupporting

confidence: 91%

“…However, we provided further data on correlations between the QRS width and morphology with the degree and type of ventricular asynchrony. In addition, we used a noninvasive technique, whereas Fauchier et al (20) used a radionuclide technique coupled with the Fourier analysis. Prolonged ventricular activation, as shown by a wide QRS complex, is common in patients with dilated cardiomyopathy (21,22) and independently impaired systolic and diastolic LV function (8,22,23).…”

Section: Discussionmentioning

confidence: 99%

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Intra-left ventricular electromechanical asynchrony

Bader

Garrigue

Lafitte

et al. 2004

Journal of the American College of Cardiology

413

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Intra-left ventricular electromechanical asynchrony

Bader

Garrigue

Lafitte

et al. 2004

Journal of the American College of Cardiology

413

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“…10 Fauchier et al have shown that the prognosis of patients with DCM is related to intraventricular rather than inter-ventricular dysynchrony. 11 In our study, the phase images from POOL-SPECT enabled us to easily visualize inter-and intraventricular asynchrony. The patients with both tended to have more deteriorated cardiac function, and experience more fatal cardiac events ( Table 2).…”

Section: Discussionmentioning

confidence: 86%

Efficacy of the Phase Images in Fourier Analysis Using Gated Cardiac POOL-SPECT for Determining the Indication for Cardiac Resynchronization Therapy

Muramatsu

Matsumoto

Nishimura

2005

Circ J

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ntraventricular conduction delay is clearly found in some patients with heart failure and these conduction abnormalities might be related to a delay in the onset of right or left ventricular (LV) contraction. Inefficient cardiac contraction caused by such mechanical asynchrony may be partly responsible for further impairment of LV function. Cardiac resynchronization therapy (CRT) restores optimum synchrony of ventricular contraction. A metaanalysis of 4 randomized controlled trials showed that the morbidity of progressive heart failure decreased by 51% after CRT, and the admission rate was decreased by 29%. [1][2][3] The aim of the present study was to evaluate ventricular asynchrony by the phase images obtained by Fourier analysis using gated cardiac pool emission computed tomography, and to evaluate whether these images can be used to determine the indication for CRT. Methods Study PatientsInitially, we examined the efficacy of phase image from pool single photon emission computed tomography (POOL-SPECT) for evaluating heart failure in 19 patients with idiopathic dilated cardiomyopathy (DCM; 16 men, 3 women; Circulation Journal Vol.69, December 2005 age 50±17 years; LV ejection fraction (LVEF): 22±9%). Of these, 3 patients were New York Heart Association (NYHA) functional class I, 7 were class II, and 9 were class III. Our definition of wide QRS was >120 ms in duration and 7 patients fitted the definition (Table 1). This study was performed consecutively and continuously between November 2001 and December 2004. All patients were treated with angiotensin-converting enzyme inhibitors, diuretics and -blockers during follow-up. In the next stage of the study, to evaluate the efficacy of the phase images for CRT setting, the 7 patients with advanced heart failure and wide QRS complex who underwent CRT were studied (5 men, 2 women; age 63±16 years; DCM 6, ischemic cardiomyopathy 1; 6 NYHA III, 1 class IIM). Phase imaging using POOL-SPECT was performed before and within 11 months (3.8±3.6 month) after CRT between October 2002 and October 2004. POOL-SPECTPOOL-SPECT was performed using technetium-99m ( 99m Tc) red blood cells with an in vivo labeling method. 99m Tc pertechnetate (740 MBq) was injected intravenously. POOL-SPECT imaging used a Prism 3000XP with a 3-headed single photon emission computed tomography (SPECT) system that had low-energy, high resolution, parallel-hole collimators. A total of 72 projection images obtained over 360 degrees every 5 degrees of rotation were acquired in 64×64 matrices on a magnetic disk with 16 frames/cardiac cycle. The data acquisition time was 40 s for each projection. Reconstructed images were made Background Although cardiac resynchronization therapy (CRT) improves quality of life and survival for patients with heart failure, exact methods to estimate the effect of cardiac asynchrony have not yet been defined. Methods and ResultsInitially, to examine whether the phase analysis images in the Fourier analysis using gated cardiac pool single photon emission computed tomography...

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“…Tournoux et al (2007) [16] looked at the true deformation of the two LV walls, but may have not fully represented the total LV mechanical dyssynchrony because there may be heterogeneous myocardial deformation, especially in ischemic cardiomyopathy. The data of Fauchier et al (2002) [27] study nicely showed that the presence of mechanical intraventricular dyssynchrony is an independent factor of worsening HF and mortality and it was inconsistent with ischemic group. Similarly, in ischemic patients it was observed in this present series that QRS duration had insignificant correlation with mechanical interventricular dyssynchrony, TPS-SD, TS-SD and TMinMax.…”

Section: Discussionmentioning

confidence: 92%

Assessment of Mechanical and Electrical Dyssynchrony in Cardiomyopathy

Morshed¹,

Ahmed²,

Zaman³

et al. 2016

AIMDR

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Background: Cardiac resynchronization therapy (CRT) had shown great promise in improving hospitalization and mortality of the patients suffering from refractory heart failure (HF) inspite of optimal medical management. The goal of CRT is to reduce cardiac mechanical dyssynchrony, thereby enabling the heart to contract more efficiently. Mechanical ventricular dyssynchrony as estimated by electrical dyssynchrony, is assessed with the QRS duration. But electrical and mechanical dyssynchrony are not well correlated in all HF patients. The dyssynchrony might have been related to the underlying etiology of HF. Objective: To compare the concordance of mechanical and electrical dyssynchrony in both ischemic and nonischemic cardiomyopathy patients. Methods: Doppler echocardiography and strain echocardiography was performed in 76 patients presenting with heart failure due to ischemic cardiomyopathy (n=40) or nonischemic cardiomyopathy (n=36) with left ventricular ejection fraction<35% & New York Heart Association class III-IV, regardless of their QRS duration. Interventricular dyssynchrony was assessed by the time interval between preaortic and prepulmonary ejection times. Intra-ventricular dyssynchrony was assessed by using conventional Doppler and strain echocardiograpy. Obtained from the three standard apical view (TMinMax) and (2) the standard deviation of the averaged time-to-peak strain (TPS-SD, ms) and (3) time to peak myocardial systolic velocity (Ts-SD) of same segments. Result: The correlation coefficient between QRS duration and mechanical interventricular dyssynchrony was significant (r=0.57, P=0.001) in patients with non-ischemic cardiomyopathy and insignificant (r=0.175, p=0.281) in patients with ischemic cardiomyoparhy. The correlation coefficient between QRS duration and mechanical intraventricular dyssynchrony was significant in patients with nonischemic cardiomyopathy (r= 0.69, P = 0.001 for TMin Max; r=0.57, P= 0.001 for TPS-SD; r=0.48, p=0.003 for TS-SD) and insignificant in patients with ischemic cardiomyopathy (r=0.153; p=0.345 for TMin Max; r=0.178; p=0.273 for TPS-SD r=0.139; p=0.392 for TS-SD). Conclusion: This study showed that the relationship between electrical and mechanical dyssynchrony is dependent on the underlying etiology of heart failure.

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Interventricular and intraventricular dyssynchrony in idiopathic dilated cardiomyopathy

Abstract: Intraventricular dyssynchrony evaluated with phase analysis of radionuclide angiography is an independent predictor of cardiac event in IDC. The prognosis is related to intraventricular rather than to interventricular dyssynchrony in IDC.

Cited by 180 publications

References 23 publications

Intra-left ventricular electromechanical asynchrony

Intra-left ventricular electromechanical asynchrony

Efficacy of the Phase Images in Fourier Analysis Using Gated Cardiac POOL-SPECT for Determining the Indication for Cardiac Resynchronization Therapy

Assessment of Mechanical and Electrical Dyssynchrony in Cardiomyopathy

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