Ventricular dyssynchrony and risk markers of ventricular arrhythmias in nonischemic dilated cardiomyopathy: A study with phase analysis of angioscintigraphy

被引:16
作者
Fauchier, L [1 ]
Marie, O
Casset-Senon, D
Babuty, D
Cosnay, P
Fauchier, JP
机构
[1] CHU Trousseau, Serv Cardiol B, F-37044 Tours, France
[2] CHU Trousseau, Nucl Med Serv, F-37044 Tours, France
来源
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY | 2003年 / 26卷 / 01期
关键词
cardiomyopathy; ventricular arrhythmias; ventricular dyssynchrony; cardiac scintigraphy;
D O I
10.1046/j.1460-9592.2003.00048.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Biventricular pacing is a newform of treatment for patients with dilated cardiomyopathy and ventricular dyssynchrony. Limited information is available regarding the relationship between ventricular dyssynchrony and risk markers of ventricular arrhythmias in idiopathic dilated cordiomyopathy (IDC). In 103 patients with IDC, Fourier phase analysis of both ventricles was performed from equilibrium radionuclide angiography (ERNA). The difference between the mean phase of the LV and RV was a measure of interventricular dyssynchrony, and the standard deviations of the mean phases in each ventricle measured intraventricular dyssynchrony. There were no significant differences in inter- and intraventricular dyssynchrony between patients with versus without histories of sustained VT or VF, nonsustained VT abnormal signal-averaged ECG, or induced sustained monomorphic VT Dyssynchrony was not related to decreased heart rate variability (HRV). LV and interventricular dyssynchrony were weakly related to QT duration and QT dispersion. During a follow-up of 27 ::L 23 months, 21 patients had major adverse cardiac events (MACE), including 7 cardiac deaths, 11 progression of heart failure leading to cardiac transplantation, and 3 sustained VT/VF. The only independent predictors of MACE were an increased standard deviation of LV mean phase (P = 0.003), a decreased HRV (standard deviation of normal-to-normal intervals, P = 0.004), and histories of previous VT/VF (P = 0.03) or nonsustained VT (P = 0.04). In conclusion, left intraventricular dyssynchrony evaluated with ERNA was an independent predictor of MACE in IDC and was not related to usual risk markers Of ventricular arrhythmias. This may have implications for resynchronization therapy and/or the use of implantable cardioverter defibrillators in IDC. (PACE 2003; 26[Pt. II]:352-356).
引用
收藏
页码:352 / 356
页数:5
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