Prognostic value of intraventricular dyssynchrony according to clinical stage of left ventricular impairment

Burgess, MI, Rozis, E and Marwick, TH (2006) Prognostic value of intraventricular dyssynchrony according to clinical stage of left ventricular impairment. American Journal of Cardiology, 98 11: 1439-1445. doi:10.1016/j.amjcard.2006.07.026


Author Burgess, MI
Rozis, E
Marwick, TH
Title Prognostic value of intraventricular dyssynchrony according to clinical stage of left ventricular impairment
Journal name American Journal of Cardiology   Check publisher's open access policy
ISSN 0002-9149
Publication date 2006-01-01
Sub-type Article (original research)
DOI 10.1016/j.amjcard.2006.07.026
Open Access Status Not yet assessed
Volume 98
Issue 11
Start page 1439
End page 1445
Total pages 7
Editor W. C. Roberts
Place of publication USA
Publisher Excerpta Medica Inc
Language eng
Subject C1
321003 Cardiology (incl. Cardiovascular Diseases)
730106 Cardiovascular system and diseases
Abstract Intraventricular dyssynchrony has prognostic implications in patients who have severe functional limitation and decreased ejection fraction. Patients with less advanced cardiac disease often exhibit intraventricular dyssynchrony, but there is little available information about its prognostic relevance in such patients. We investigated the prognostic effect of intraventricular dyssynchrony on outcome in 318 patients with known or suspected coronary artery disease who were classified according to the presence or absence of left ventricular dysfunction and heart failure symptoms. Mortality was considered the primary end point over a median follow-up of 56 months, and a Cox proportional hazards model was used for survival analysis. Despite a low prevalence (8%) of left bundle branch block, there was a high prevalence of intraventricular dyssynchrony even in patients without symptomatic heart failure. The magnitude of intraventricular dyssynchrony correlated poorly with QRS duration (r = 0.25),end-systolic volume index (r = 0.27), and number of scar segments (r = 0.25). There,were 58 deaths during follow-up. Ventricular volume, ischemic burden, and magnitude of intraventricular dyssynchrony predicted outcome, but magnitude of intraventricular dyssynchrony was an independent predictor of survival only in patients with asymptomatic left ventricular dysfunction. In conclusion, patients with known or suspected coronary artery disease have a high prevalence of intraventricular dyssynchrony. Although ventricular volume, ischemic burden, and intraventricular dyssynchrony are potentially important prognostic markers, the relative importance of intraventricular dyssynchrony changes with the clinical setting and, may be greatest-in patients with preclinical disease. (c) 2006 Elsevier Inc. All rights reserved.
Keyword Cardiac & Cardiovascular Systems
Congestive-heart-failure
Cardiac Resynchronization Therapy
Qrs Duration
Ejection Fraction
Echocardiography
Mortality
Performance
Dysfunction
Prediction
Asynchrony
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2007 Higher Education Research Data Collection
School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 5 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 5 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Wed, 15 Aug 2007, 19:56:30 EST