Impact of elective PCI on left intraventricular mechanical dyssynchrony in patients with chronic stable angina (tissue Doppler study)

Mostafa, Shaimaa; Mansour, Heba; Aboelazm, Tarek Helmy; Elrabat, Khaled; Sabry, A.M.

doi:10.1016/j.ehj.2014.10.002

Cited by 3 publications

(4 citation statements)

References 12 publications

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“…LV desynchrony was initially recognized as a phenomenon related to electrical conduction delay in patient with systolic heart failure with wide QRS complexes which is associated with worsening of symptoms and poor prognosis so; CRT is an important non-pharmacological therapy in end-stage heart failure if optimal heart failure therapy failed [7].…”

Section: Discussionmentioning

confidence: 99%

Clinical, electrical, and functional changes following CRT-P implantation: short-term results in patients with non-ischaemic cardiomyopathy

Mostafa,

Abdelmoneim,

Ramadan

et al. 2024

Racionalʹnaâ farmakoterapiâ v kardiologii

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Aim. Assessment of the correlation between cardiac remodeling, functional status and electrical remodeling after cardiac resynchronisation therapy (CRT) in patients with non-ischaemic cardiomyopathy.Material and methods. A single center, prospective, observational study included 50 patients with non-ischaemic cardiomyopathy who were candidate for CRT implantation. All patients prior to CRT and then 3 months after implantation had standard 12-lead surface ECGs to assess QRSd for assessment electrical response, for assessment of left ventricular ejection fraction (LVEF) and volumes (left ventricular end diastolic and systolic volume, LVEDV and LVESV), mitral regurgitation (degree of mitral regurgitation), pulmonary artery systolic pressure (for diagnosis of pulmonary hypertension), NYHA class and 6 minute walk test (6MWT) to assess patient’s functional capacity.Results. 50 patients with CRT were included (35 males and 15 females, mean age 54.88±7.48 years). All patients were in sinus rhythm with QRS duration (QRSd) ≥120 ms, EF<35% and left bundle branch block. After 3 months; there was significant improvement in QRSd in 82% of the cases (145.3±16.3 ms vs 133.3±17.2 ms, p<0.001). NYHA class improved at least one class in 78% and 6 min walk test improved in 80% (168.5 [131.0; 181.0] m vs 280.0 [237.0; 297.0] m, p<0.001). LVEF increased significantly in 74% of study cases (28.6±2.7 vs 34.5±3.1, p value 0.001) also there were statistically significant improvement in LVEDV (267.0±45.7 to 221.8±41.9 ml, p=0.002) and LVESV (137.43±47.19 to 105.03±42.7 ml, p=0.003). There was statistically significant correlation between QRSd and NYHA class (r=0.392, p=0.005), QRSd and 6MWT (r=0.323, p=0.022) and QRSd with LVEF (r=0.672 with p<0.001). Only seven patients showed improvement in the 3 parameters: LVESV, QRS duration and 6 min walk test.Conclusion. The CRT-pacemaker implantation was associated with significant improvement in QRSd, NYHA class, 6MWT and LV volumes in the short-term period. QRSd improvement was significantly correlated with functional status and LV EF.

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Section: Discussionmentioning

confidence: 99%

Clinical, electrical, and functional changes following CRT-P implantation: short-term results in patients with non-ischaemic cardiomyopathy

Mostafa,

Abdelmoneim,

Ramadan

et al. 2024

Racionalʹnaâ farmakoterapiâ v kardiologii

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“…Earlier, even the protective value of PCI to LVMD is supported by the studies in which the most of are focused on examining the acute effects of PCI and have been done mostly with tissue Doppler echocardiography. 28 , 29 Elective PCI as well as PCI in acute phase ST elevation infarct has found to improve LVMD significantly. 28 , 29 LVMD within 48 hours after PCI has seemed to predict increase in LV size and deterioration of LV systolic function after 6 months follow up.…”

Section: Discussionmentioning

confidence: 99%

“… 28 , 29 Elective PCI as well as PCI in acute phase ST elevation infarct has found to improve LVMD significantly. 28 , 29 LVMD within 48 hours after PCI has seemed to predict increase in LV size and deterioration of LV systolic function after 6 months follow up. 30 This suggests that a significant degree of LVMD is predictive of adverse LV remodeling and may offer a possibility to identify patients at risk for LV remodeling early after infarction and to consequently emphasize intensive treatments for these patients.…”

Section: Discussionmentioning

confidence: 99%

Myocardial ischemia and previous infarction contribute to left ventricular dyssynchrony in patients with coronary artery disease

Hämäläinen

Corovai

Laitinen

et al. 2021

Journal of Nuclear Cardiology

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The aim of this study was to characterize determinants of left ventricular mechanical dyssynchrony (LVMD) in patients with coronary artery disease (CAD).Methods. Medical records and results of myocardial perfusion SPECT/CT studies were evaluated in 326 patients with previously diagnosed CAD. LVMD was assessed with the phase analysis of ECG-gated myocardial SPECT. Dyssynchrony was described with phase histogram bandwidth (PHBW), standard deviation (PHSD) or entropy (PHE) values above limit of the highest normal.Results. Prevalence of LVMD was 29% in CAD patients. Size of the infarction scar and ischemia extent correlated significantly with PHBW, PHSD and PHE (P < 0.001 for all). Independent predictors of LVMD were myocardial infarction scar (P = 0.004), ischemia extent (P = 0.003), and QRS duration (P = 0.003). Previous percutaneous coronary intervention and coronary artery bypass grafting did not independently predict dyssynchrony.Conclusions. Almost one-third of CAD patients had significant LVMD. Dyssynchrony was associated with earlier myocardial infarction and presence of myocardial ischemia. Previous percutaneous coronary intervention and coronary artery bypass grafting did not independently predict dyssynchrony. (J Nucl Cardiol 2020

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“…Они показали, что механическая диссинхрония после ЧКВ улучшилась на 21,02% по сравнению с исходными значениями, а через месяц после ЧКВ -на 41,69%. По данным speckle tracking эхокардиографии после ЧКВ отмечено улучшение характеристик продольной деформации во всех сегментах (p<0,001) [12,13].…”

Section: Discussionunclassified

The Effect of Clinical Characteristics and Stent Parameters on Left Ventricular Mechanical Dyssynchrony

Mostafa

Sanad

Shawky

et al. 2021

Racionalʹnaâ farmakoterapiâ v kardiologii

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Aim. To study short term effect of stent size and number on left ventricular mechanical dyssynchrony after elective percutaneous coronary intervention (PCI) to left anterior descending (LAD) artery.Materials and methods. the study included 150 adult patients with LAD lesion treated with PCI using drug-eluting stent. Patients were evaluated pre PCI then 1 month and 3 months post PCI for evaluation of mechanical dyssynchrony using tissue synchronization image (TSI).Results. Before revascularization mean left ventricular ejection fraction was 51.2±5.7 %, mean time to peak TSI was 213.6±10.9 ms; 1 month after PCI TSI improved significantly to 163.7±17.6 ms (p<0.001), 3 months after PCI showed more improvement to 120.7±26.9 ms (p<0.001). After 3m; 61 patients (40.7%) showed recovery to normal TSI value. The predictors of non-improvement of time to peak TSI after 3 months were diabetes mellitus (p=0.007), dyslipidemia (p=0.001) and stent length (p=0.001), number of stents (p=0.004). There were strong negative correlation between stent length and improvement of the time to peak TSI at 1 month (r=-0.352, p<0.001) and at 3 months (r=-0.509, p<0.001),and also with number of stent at 1 month (r= -0.173, p=0.034) and at 3 months (r=-0.499, p<0.001), but the correlation between stent diameter and improvement of the TSI wasn’t significant neither at 1 month nor at 3 months (r=0.055, p=0.504 and r= -0.018, p=0.827) respectively.Conclusion. Increased number and length of the implanted stents were predictors to non-improvement of mechanical dyssynchrony, while stent diameter didn’t affects the recovery.

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Impact of elective PCI on left intraventricular mechanical dyssynchrony in patients with chronic stable angina (tissue Doppler study)

Cited by 3 publications

References 12 publications

Clinical, electrical, and functional changes following CRT-P implantation: short-term results in patients with non-ischaemic cardiomyopathy

Clinical, electrical, and functional changes following CRT-P implantation: short-term results in patients with non-ischaemic cardiomyopathy

Myocardial ischemia and previous infarction contribute to left ventricular dyssynchrony in patients with coronary artery disease

The Effect of Clinical Characteristics and Stent Parameters on Left Ventricular Mechanical Dyssynchrony

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