Fazelifar, A.F. and Bonakdar, H.R. and Alizadeh, K. and Azarnik, H. and Haghjoo, M. and Abkenar, H.B. and Samiei, N. and Sadr-Ameli, M.A. (2008) Relationship between QRS complex notch and ventricular dyssynchrony in patients with heart failure and prolonged QRS duration. Cardiology Journal, 15 (4). pp. 351-356.
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Relationship between QRS complex notch and ventricular dyssynchrony in patients with heart failure and prolonged QRS duration.pdf Download (94kB) | Preview |
Abstract
Background: Cardiac resynchronization therapy (CRT) has been accepted as an established therapy for advanced systolic heart failure. Electrical and mechanical dyssynchrony are usually evaluated to increase the percentage of CRT responders. We postulated that QRS notch can increase mechanical LV dyssynchrony independently of other known predictors such as left ventricular ejection fraction and QRS duration. Methods: A total of 87 consecutive patients with advanced systolic heart failure and QRS duration more than 120 ms with an LBBB-like pattern in V1 were prospectively evaluated. Twelve-lead electrocardiogram was used for detection of QRS notch. Complete echocardiographic examination including tissue Doppler imaging, pulse wave Doppler and M-mode echocardiography were done for all patients. Results: Eighty-seven patients, 65 male (75) and 22 female (25), with mean (SD) age of 56.7 (12.3) years were enrolled the study. Ischemic cardiomyopathy was the underlying heart disease in 58 of the subjects, and in the others it was idiopathic. Patients had a mean (SD) QRS duration of 155.13 (23.34) ms. QRS notch was seen in 49.4 of the patients in any of two precordial or limb leads. Interventricular mechanical delay was the only mechanical dyssynchrony index that was significantly longer in the group of patients with QRS notch. Multivariate analysis revealed that the observed association was actually caused by the effect of QRS duration, rather than the presence of notch per se. Conclusions: QRS notch was not an independent predictor of higher mechanical dyssynchrony indices in patients with wide QRS complex and symptomatic systolic heart failure; however, there was a borderline association between QRS notch and interventricular delay. © 2008 Via Medica.
| Item Type: | Article |
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| Additional Information: | cited By 5 |
| Uncontrolled Keywords: | adult; aged; article; Doppler echocardiography; electrocardiography; female; heart muscle ischemia; heart pacing; heart stroke volume; heart ventricle; hospitalization; human; male; methodology; middle aged; multivariate analysis; pathophysiology; physiology; prediction and forecasting; prognosis; prospective study; risk assessment; sensitivity and specificity; systolic heart failure, Adult; Aged; Cardiac Pacing, Artificial; Echocardiography, Doppler, Pulsed; Electrocardiography; Female; Heart Failure, Systolic; Heart Ventricles; Humans; Male; Middle Aged; Multivariate Analysis; Myocardial Ischemia; Predictive Value of Tests; Prognosis; Prospective Studies; Risk Assessment; Sensitivity and Specificity; Severity of Illness Index; Stroke Volume |
| Subjects: | WG Cardiovascular System |
| Depositing User: | Arezoo Ghasemi siani |
| Date Deposited: | 27 Jan 2021 05:33 |
| Last Modified: | 27 Jan 2021 05:33 |
| URI: | http://eprints.iums.ac.ir/id/eprint/22726 |
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