Left bundle-branch block is associated with increased 1-year sudden and total mortality rate in 5517 outpatients with congestive heart failure: A report from the Italian network on congestive heart failure

Baldasseroni, Samuele; Opasich, Cristina; Gorini, Marco; Lucci, Donata; Marchionni, Niccolò; Marini, Maurizio; Campana, Carlo; Perini, G.; Deorsola, A.; Masotti, Giulio; Tavazzi, Luigi; Maggioni, Aldo P.

doi:10.1067/mhj.2002.121264

Cited by 689 publications

(410 citation statements)

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“…Dyssynchrony is associated with diastolic (2,3) and systolic heart failure (1,4) leading to an impaired outcome in patients with dilated cardiomyopathy (DCM), particularly in the presence of a left bundle branch block (LBBB) (2,5). Cardiac resynchronization therapy (CRT) improves prognosis in most of these patients (4).…”

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confidence: 99%

Magnetic resonance tissue phase mapping: Analysis of age‐related and pathologically altered left ventricular radial and long‐axis dyssynchrony

Föll

Jung²,

Germann

et al. 2011

Magnetic Resonance Imaging

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Purpose: To employ magnetic resonance tissue phase mapping (TPM) for the assessment of age-related left ventricular (LV) synchrony of radial and long-axis motion in healthy volunteers and in hypertensive heart disease, dilated cardiomyopathy (DCM), and left bundle branch block (LBBB).Materials and Methods: TPM (spatial/temporal resolution ¼ 1.3 Â 2.6 mm 2 /13.8 msec) was employed to measure radial and long-axis myocardial velocities in 58 healthy volunteers of three age groups and 37 patients (hypertensive, n ¼ 18; DCM, n ¼ 12; DCM and LBBB n ¼ 7). Regional times-to-peak velocities (TTP) in systole and diastole were derived for all LV segments. Four measures of dyssynchrony were defined as the standard deviation of systolic and diastolic TTP for radial and long-axis motion.Results: Systolic radial and diastolic long-axis dyssynchrony was increased (P < 0.01) in all patient groups compared to controls. Multiple regressions revealed a significant relationship of dyssynchrony with LV ejection fraction and mass for systolic radial (P < 0.001 resp. P ¼ 0.02), diastolic radial (P < 0.001 resp. P < 0.05), and long-axis (P < 0.001 resp. P ¼ 0.001) motion. Diastolic dyssynchrony correlated with the LV remodeling index (P < 0.05) and increased with age (P < 0.03). Systolic long-axis dyssynchrony was not influenced by disease or LV function. Conclusion:Radial systolic and long-axis diastolic dyssynchrony were the most sensitive markers for altered dyssynchrony in hypertensive heart disease or DCM. Future studies are needed to evaluate the diagnostic value of TPM-derived dyssynchrony parameters.

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confidence: 99%

Magnetic resonance tissue phase mapping: Analysis of age‐related and pathologically altered left ventricular radial and long‐axis dyssynchrony

Föll

Jung²,

Germann

et al. 2011

Magnetic Resonance Imaging

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“…1 LV dyssynchrony is known to impair the function of a failing ventricle, resulting in the worsening of symptoms and clinical outcomes in patients with HF. 24,25 LV dyssynchrony is associated with the development of LV remodeling after acute myocardial infarction 26 and increases the risk of new-onset HF in patients with hypertension. 27 The effects of medical treatment on dyssynchrony in patients with CAD, 28 hypertrophic cardiomyopahthy, 29 dilated cadiomyopathy 30 and HF [30][31][32] have been reported, but patients with hypertension and a structurally normal heart have not been evaluated.…”

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confidence: 99%

Impact of antihypertensive treatment on left ventricular systolic dyssynchrony in treatment-naïve hypertensive patients

et al. 2012

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Dyssynchrony is common in asymptomatic patients with hypertension. We sought to investigate the impact of antihypertensive treatment on dyssynchrony in patients with hypertension. A total of sixty patients who had uncomplicated hypertension that had never been treated (treatment-naïve hypertensive patients) underwent echocardiographic evaluations of left ventricular (LV) dyssynchrony at baseline and after a 6-month treatment with antihypertensive drugs. The measured parameters were as follows:(1) the s.d. of 12 LV-segment time-to-peak systolic velocities (Ts-SD12), and (2) the maximal difference between peak systolic velocities of any 2 of the 12 segments (Ts-Max). Patients with Ts-SD12 X33 ms or Ts-Max X100 ms were regarded as having LV systolic dyssynchrony. Patients with systolic dyssynchrony (group 1, n¼29) and without systolic dyssynchrony (group 2, n¼31) were compared. Among the patients in group 1, antihypertensive treatment significantly improved LV systolic dyssynchrony (DTs-SD12, À13.1 ms; Po0.001 and DTs-Max, À34.0 ms; P¼0.003), whereas it did not demonstrate additional benefit among group 2 patients. The change in LV systolic dyssynchrony was significantly associated with changes in the mean annulus E¢ velocity, mean annulus S¢ velocity and mean annulus E¢/A¢ ratio, but not with changes in blood pressure and LV mass index. It is likely that chronic antihypertensive treatment could reverse the LV systolic dyssynchrony and simultaneously improve subclinical systolic and diastolic function in patients with hypertension and LV systolic dyssynchrony. INTRODUCTIONIt is well known that left ventricular (LV) systolic or diastolic dyssynchrony is common in patients with heart failure (HF) and a normal QRS duration. 1 There has been increased recognition that LV dyssynchrony also exists in patients without HF but with other cardiac diseases, including hypertension, 2 coronary artery disease (CAD) 3 and cardiomyopathy. 4,5 Dyssynchrony has been measured using a variety of echocardiographic parameters based on different imaging techniques, 6 including pulsed-wave tissue Doppler imaging (TDI), colorcoded TDI, tissue tracking, displacement mapping, strain and strain rate imaging, and tissue synchronization imaging. TDI is the most extensively tested method.Hypertension is a major risk factor for LV hypertrophy and HF. Epidemiological studies have demonstrated that hypertension accounts for 50% of patients with HF. 7 Recently, it was demonstrated that LV systolic dyssynchrony was present in 24% of asymptomatic patients with hypertension. 2 Moreover, on the basis of results from the previous study, 8 the proportion of treatment-naïve hypertensives with LV systolic dyssynchrony was found to be 44.5%.

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“…En pacientes con IC es frecuente la presencia de trastornos de conducción intraventricular 3 , en especial bloqueo completo de rama izquierda (BCRI). Este trastorno se traduce en un patrón anormal de activación del ventrículo izquierdo (VI), con contracción tardía de la pared lateral respecto al septum, y la pérdida de la sincronía ventricular conduce a deterioro progresivo de la función contráctil.…”

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Terapia de resincronización en pacientes con insuficiencia cardiaca: experiencia acumulada de 10 años

et al. 2013

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Left bundle-branch block is associated with increased 1-year sudden and total mortality rate in 5517 outpatients with congestive heart failure: A report from the Italian network on congestive heart failure

Cited by 689 publications

References 36 publications

Magnetic resonance tissue phase mapping: Analysis of age‐related and pathologically altered left ventricular radial and long‐axis dyssynchrony

Magnetic resonance tissue phase mapping: Analysis of age‐related and pathologically altered left ventricular radial and long‐axis dyssynchrony

Impact of antihypertensive treatment on left ventricular systolic dyssynchrony in treatment-naïve hypertensive patients

Terapia de resincronización en pacientes con insuficiencia cardiaca: experiencia acumulada de 10 años

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