Utility of QRS width and echocardiography parameters in an integrative algorithm for selecting heart failure patients with cardiac dyssynchrony

Jurcuţ, Ruxandra; Pop, Ioana; Calin, Cosmin; Coman, Ioan Mircea; Ciudin, Radu; Ginghină, Carmen

doi:10.1016/j.ejim.2008.07.006

Cited by 7 publications

(9 citation statements)

References 41 publications

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“…A greater proportion of patients with inter-VD was observed in group 1 (QRS ≥ 120 ms) compared to patients in group 2 ( p = 0.03) (Table 4). This is in accordance with other series of patients 6,8,10,11…”

Section: Discussionsupporting

confidence: 94%

“…Data in the literature showed a good correlation between the IVMD and the width of the QRS 6,10-12. This correlation improved slightly when patients with pulmonary hypertension or right ventricular dysfunction were excluded 12…”

Section: Discussionmentioning

confidence: 92%

“…Jurcut et al 6. found the prevalence of AVD was 45% among 58 patients hospitalised for DCM of different aetiologies.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of cardiac dyssynchrony and correlation with atrio-ventricular block and QRS width in dilated cardiomyopathy : an echocardiographic study : cardiovascular topics

Anzouan-Kacou¹,

N’Cho-Mottoh²,

Konin³

et al. 2012

CVJA

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IntroductionCardiac dyssynchrony causes disorganised cardiac contraction, delayed wall contraction and reduced pumping efficiency. We aimed to assess the prevalence of different types of dyssynchrony in patients with dilated cardiomyopathy (DCM), and to establish the correlation between atrio-ventricular block and atrio-ventricular dyssynchrony (AVD), and between impaired intra-ventricular conduction and the existence of inter-ventricular dyssynchrony (inter-VD) and intra-left ventricular dyssynchrony (intra-LVD).MethodsWe included 40 patients in New York Heart Association stage III or IV, admitted consecutively with DCM with severe left ventricular dysfunction (left ventricular end-diastolic diameter ≥ 60 mm and/or ≥ 30 mm/m2) and left ventricular ejection fraction < 35%. Electrocardiographic and echocardiographic data were evaluated in all patients. Patients were divided into two groups: group 1: eight patients, with a QRS duration ≥ 120 ms, and all presented with left bundle branch block; group 2: 32 patients with a narrow QRS < 120 ms.ResultsOverall, the mean age was 54.7 ± 16.8 years and patients in group 1 were older (67.2 ± 13.6 vs 51.5 ± 15.8 years, p = 0.01). The prevalence of atrio-ventricular dyssynchrony (AVD), inter-VD and intra-LVD was respectively 40, 47.5 and 70%. Two patients (5%) did not exhibit dyssynchrony. AVD was present with a similar frequency in the two groups (37.5% in group 1 vs 40.6% in group 2, p = 0.8). There was no correlation of the magnitude of AVD with the duration of the PR interval (from the beginning of the P wave to the beginning of the QRS complex) (r2 = 0.02, p = 0.37) or the QRS width (r2 = 0.01, p = 0.38). A greater proportion of patients with inter-VD was observed in group 1 (87.5 vs 60%, p = 0.03). There was a trend towards a more important inter-ventricular mechanical delay according to QRS width (r2 = 0.009, p = 0.06). The proportion of intra-LVD was similar in all groups, with a high prevalence (87.5% in group 1 and 65.6% in group 2, p = 0.39).ConclusionThe assessment of cardiac dyssynchrony is possible in our country. Intra-ventricular mechanical dyssynchrony had a high prevalence in patients with DCM, irrespective of the QRS width. These data emphasise the usefulness of echocardiography in the screening of patients.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 92%

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Prevalence of cardiac dyssynchrony and correlation with atrio-ventricular block and QRS width in dilated cardiomyopathy : an echocardiographic study : cardiovascular topics

Anzouan-Kacou¹,

N’Cho-Mottoh²,

Konin³

et al. 2012

CVJA

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“…La largeur du QRS est une évaluation électrocardiographique, l'asynchronisme est un phénomène anatomique et mécanique. L'existence des critères écho-Doppler cardiaques d'asynchronisme chez les patients avec dysfonction systolique ventriculaire gauche et à QRS fin a déjà largement été signalée par plusieurs auteurs [9][10][11]. Cependant, l'étude PROSPECT [16] a identifié des limites des critères échocardiographiques et Doppler pour analyser les asynchronismes, notamment la mauvaise reproductibilité et faisabilité de plusieurs critères.…”

Section: Discussionunclassified

“…L'évaluation des asynchronismes cardiaques en écho-Doppler cardiaque a pour principal intérêt de préciser l'indication d'une resynchronisation. Les critères actuels de décision d'une resynchronisation excluent les patients ayant un complexe QRS fin (< 120 ms) à l'électrocardiogramme [8], ceux-ci pouvant cependant présenter un asynchronisme intraventriculaire gauche [9][10][11] dans 30 à 72 % des cas. Un asynchronisme peut être retrouvé chez des patients exempts de dysfonction systolique ventriculaire gauche [12].…”

Section: Introductionunclassified

Asynchronisme cardiaque chez le sujet à QRS fin. Étude par échocardiographie Doppler tissulaire

2012

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Relationship between fragmented QRS and response to cardiac resynchronization therapy

Ağaçdiken

Şahı̇n

et al. 2012

J Interv Card Electrophysiol

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Utility of QRS width and echocardiography parameters in an integrative algorithm for selecting heart failure patients with cardiac dyssynchrony

Cited by 7 publications

References 41 publications

Prevalence of cardiac dyssynchrony and correlation with atrio-ventricular block and QRS width in dilated cardiomyopathy : an echocardiographic study : cardiovascular topics

Prevalence of cardiac dyssynchrony and correlation with atrio-ventricular block and QRS width in dilated cardiomyopathy : an echocardiographic study : cardiovascular topics

Asynchronisme cardiaque chez le sujet à QRS fin. Étude par échocardiographie Doppler tissulaire

Relationship between fragmented QRS and response to cardiac resynchronization therapy

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