Echocardiographic evaluation of mechanical dyssynchrony in heart failure patients with reduced ejection fraction

Abstract

Abstract. The aim of this study is to observe the differences between mechanical and electrical dyssynchrony in patients with impaired systolic ventricular function and symptomatic heart failure and to highlight the importance of mechanical dyssynchrony besides electrical dyssynchrony in clinical guidelines and clinical practice. Fifty-eight patients with heart failure, who are with the New York Heart Association (NYHA) functional class II-IV and left ventricular ejection fraction (LVEF) under 35%, were enrolled. Patients were divided into two groups, according to the duration of QRS complex (> 120 ms and 120 ms respectively). Echocardiographic parameters of interventricular (interventricular mechanical delay -IMD) and intraventricular (septal-to-posterior wall motion delay -SPWMD) dyssynchrony were measured in both groups. Results indicate that the duration of the QRS complex (i.e. electrical dyssynchrony) is not a fully reliable indicator of ventricular dyssynchrony; therefore ecocardiographic evaluation of mechanical dyssynchrony should also be recommended for better selection of candidates for cardiac resynchronization therapy (CRT).

Predictors and outcomes of Cardiac Dyssynchrony among patients with heart failure attending Benjamin Mkapa Hospital in Dodoma, central Tanzania: A protocol of prospective-longitudinal study

“…Cardiac dyssynchrony is a phenomenon where there is delayed electrical activation in the cardiac myocytes (electrical dyssynchrony) or uncoordinated contraction of the cardiac ventricular walls (mechanical dyssynchrony), which can be either be between the segment of the cardiac ventricles (intraventricular dyssynchrony) or between the left and right ventricles (interventricular dyssynchrony) [7,8] Prevalence of Electrical Dyssynchrony has been found to depend on the aetiology of heart failure [10]. Generally, it is as high as 11% in established heart failure patients, while in dilated cardiomyopathy is estimated to be 72.4% [8,9]. As for mechanical dyssynchrony, interventricular dyssynchrony has been found to be 79% while intraventricular is 75% [4,10].…”

Predictors and outcomes of cardiac dyssynchrony among patients with heart failure attending Benjamin Mkapa Hospital in Dodoma, central Tanzania: A protocol of prospective-longitudinal study

“…Cardiac dyssynchrony is a phenomenon where there is delayed electrical activation in the cardiac myocytes (electrical dyssynchrony) or uncoordinated contraction of the cardiac ventricular walls (mechanical dyssynchrony), which can be either between the segment of cardiac ventricles (intraventricular dyssynchrony) or between the left and right ventricles (interventricular dyssynchrony) [7,8] Prevalence of Electrical Dyssynchrony has been found to depend on the aetiology of heart failure [10]. Generally, it is as high as 11% in established heart failure patients, while in dilated cardiomyopathy is estimated to be 72.4% [8,9]. As for mechanical dyssynchrony, interventricular dyssynchrony has been found to be 79% while intraventricular is 75% [4,10].…”