Left Ventricular Diastolic Dyssynchrony in Post-Myocardial Infarction Patients: Does It Predict Future Left Ventricular Remodeling?

Lee, Ju-Hee

doi:10.4250/jcu.2016.24.3.193

Cited by 5 publications

(3 citation statements)

References 18 publications

(22 reference statements)

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“…The relationship between AS and mechanical dyssynchrony is likely multifactorial and may involve afterload, LV mass and/or myocardial ischemia. 22,23 Indeed, global ischemia might have a differential effect on different myocardial segments. 18,19 In human studies, increased afterload may also accentuate LV systolic dyssynchrony even in normal subjects.…”

Section: Discussionmentioning

confidence: 99%

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Changes in mechanical dyssynchrony in severe aortic stenosis patients undergoing transcatheter aortic valve replacement

et al. 2019

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Introduction Aortic stenosis (AS) imposes a significant afterload on the left ventricle, but regional manifestations of the overall load may not be uniform, leading to mechanical dyssynchrony. Accordingly, we evaluated the prevalence of dyssynchrony in patients with severe AS at baseline as well as changes after transfemoral aortic valve replacement (TAVR). Methods This study is a retrospective analysis of 225 patients in sinus rhythm who underwent TAVR for severe AS, in whom inter‐ventricular and intra‐ventricular dyssynchrony were measured at baseline, discharge, 1 month, and 1 year. Inter‐ventricular dyssynchrony was defined as the difference between left and right ventricular pre‐ejection intervals; intra‐ventricular dyssynchrony was defined as the difference between time to peak systolic velocity of the basal septal and lateral segments. Patients were further stratified into those with QRS <120 ms or >120 ms. Results At baseline, a quarter of patients met the criterion for significant inter‐ventricular dyssynchrony, and a third had evidence of intra‐ventricular dyssynchrony. Both decreased after TAVR although only the intra‐ventricular dyssynchrony reached statistical significance. The interplay between QRS duration and changes in inter‐ and intra‐ventricular dyssynchrony are also explored. Conclusions In patients with severe AS, there was evidence of mechanical dyssynchrony that is improved post‐TAVR. Whether dyssynchrony is clinically and prognostically significant, and if it represents a potential target for additional therapy remains to be studied.

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Section: Discussionmentioning

confidence: 99%

“…Thirdly, myocardial ischemia is another potential cause for LV dyssynchrony in patients with aortic stenosis and was described in the previous studies in relationship to coronary artery disease. 22,23 Indeed, global ischemia might have a differential effect on different myocardial segments.…”

Section: Discussionmentioning

confidence: 99%

Changes in mechanical dyssynchrony in severe aortic stenosis patients undergoing transcatheter aortic valve replacement

et al. 2019

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show abstract

“…Importantly, systolic and diastolic LVMD have different underlying mechanisms and determinants and have independent predictive utility. [5][6][7] Measuring LVMD has a prognostic value in a number of patient cohorts. Patients with heart failure and a reduced ejection fraction without history of myocardial infarction, who had significant LVMD had a higher risks of cardiac events irrespective of QRS width and ejection fraction.…”

Section: See Related Article Pp 419-430mentioning

confidence: 99%