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Ventricular dyssynchrony is common among heart failure patients with narrow QRS Complex

Yaacob Z.H., and Syed Tamin S., and Nik Zainal N.H., and Chee, K.H., and Chong, W.P., and Hashim N.E., and Singh, R., and Zainal Abidin I., and Haron H., and Wan Hashim WA., (2009) Ventricular dyssynchrony is common among heart failure patients with narrow QRS Complex. Journal of the University of Malaya Medical Centre (JUMMEC), 12 (2). pp. 57-62. ISSN 1823-7339

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Official URL: http://jummec.um.edu.my

Affiliations

University of Malaya Medical Centre. Department of Medicine
University of Malaya Medical Centre. Department of Medicine
University of Malaya Medical Centre. Department of Medicine
University of Malaya Medical Centre. Department of Medicine
University of Malaya Medical Centre. Department of Medicine
University of Malaya Medical Centre. Department of Medicine
University of Malaya Medical Centre. Department of Medicine
University of Malaya Medical Centre. Department of Medicine
University of Malaya Medical Centre. Department of Medicine
University of Malaya Medical Centre. Department of Medicine

Abstract

Current selection guideline for CRT uses broad QRS duration (>120 ms) as a marker for ventricular dyssynchrony. However, more recent data supports mechanical marker specifically measured by Tissue Doppler Imaging (TDI) as a better criterion to predict response to CRT. Sixty seven patients with significant left ventricular dysfunction (EF less than 40%) and narrow QRS complex were prospectively enrolled. They underwent Tissue Doppler Imaging (TDI) study to evaluate intraventricular mechanical dyssynchrony. Dyssynchrony index which is defined as standard deviation of time to peak systolic velocity in twelve ventricular segments was measured. A value greater than 32.6 is taken to reflect significant ventricular dyssynchrony. Overall 38 patients (56.7%) demonstrated significant dyssynchrony. There was no significant correlation between QRS duration and the Ts-SD-12 (r = 0.14, p = 0.11). Ventricular mechanical dyssynchrony is common in patients with normal QRS duration. Therefore, QRS duration alone will miss a substantial proportion of suitable patients for CRT and therefore deny them this adjunct therapy. We propose echocardiographic parameters, specifically TDI, to be included in patient selection criteria for CRT.

Item Type:Journal
Keywords:oab, luts, validation, translation, questionnaire
Subjects:R Medicine, Dentistry, Pharmacy, Nursing
ID Code:11211

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