QRS width does not reflect ventricular dyssynchrony in patients with heart failure

被引：7

作者：

Uchiyama T. ^{[1
]}

Matsumoto K. ^{[1
]}

Suga C. ^{[1
]}

Kato R. ^{[1
]}

Nishimura S. ^{[1
]}

机构：

[1] Division of Cardiology, Department of Internal Medicine, Saitama Medical School, Iruma-gun, Saitama 350-0495, 38 Moro-Hongo, Moroyama-cho

来源：

Journal of Artificial Organs | 2005年 / 8卷 / 2期

关键词：

Cardiac resynchronization therapy; Dyssynchrony; Indication; Intraventricular conduction disturbance; Pace-maker;

D O I：

10.1007/s10047-005-0287-y

中图分类号：

学科分类号：

摘要：

The purpose of this study was to evaluate QRS width as an indication for cardiac resynchronization therapy. This study group consisted of 64 heart failure patients (51 men, age average 60.5 ± 15.5 years) with a left ventricular ejection fraction (LVEF) of less than 35%. Patients were divided into two groups according to their QRS width; the wide QRS group (QRS width greater than or equal to 120ms, 31 patients) and the narrow QRS group (QRS width less than 120ms, 33 patients). The ventricular dyssynchrony (VD), i.e., the inter- and intraventricular dyssynchrony, of the two groups was compared. The correlation between QRS width and VD was evaluated in all patients. There were no significant differences between the wide and the narrow QRS groups concerning interventricular dyssynchrony [28.4 ± 26.1ms vs. 25.3 ± 18.2ms, not significant (NS)] or intraventricular dyssynchrony (99.0 ± 43.8ms vs. 109.0 ± 56.6ms, NS). Nor were there any differences in the LVEF (26.6 ± 6.6% vs. 28.2 ± 5.1%, NS), brain natriuretic peptide (BNP) (567.0 ± 319.0 pg/ml vs. 390.0 ± 375.8 pg/ml, NS), and New York Heart Association (NYHA) class (2.4 ± 0.8 vs. 2.0 ± 1.0, NS). QRS width did not correlate with interventricular (r = 0.026, NS) or intraventricular dyssynchrony (r = 0.052, NS). There were no differences in VD between the two groups based on differences in QRS width. There was also no correlation between QRS width and VD. It is suggested that QRS width is not an absolute indication for cardiac resynchronization therapy. © The Japanese Society for Artificial Organs 2005.

引用

页码：100 / 103

页数：3

共 16 条

[1]

Havranek E.P., Masoudi F.A., Westfall K.A., Wolfe P., Ordin D.L., Krumholz H.Z., Spectrum of heart failure in older patients: Results from the national heart failure project, Am Heart J, 143, pp. 412-417, (2002)

[2]

Aaronson K.D., Schwarz J.S., Cheu T.-M., Wong K.-L., Goin J.E., Mancini D.M., Development and prospective validation of a clinical index to predict survival in ambulatory patients referred for cardiac transplant evaluation, Circulation, 95, pp. 2660-2667, (1997)

[3]

Xiao H.B., Brecker S.J., Gibson D.G., Effects of abnormal activation on the time course of the left ventricular pressure pulse in dilated cardiomyopathy, Br Heart J, 68, pp. 403-407, (1992)

[4]

Gregoratos G., Abrams J., Epstein A.E., Freedman R.A., Hayes D.L., Hlatky M.A., Kerber R.E., Naccarelli G.V., Schoenfeld M.H., Silka M.J., Winters S.L., ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices - Summary article: A report of the American Collage of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/NASPE Committe to Update the 1998 Pacemaker Guidelines), J Am Coll Cardiol, 40, pp. 1703-1719, (2002)

[5]

Abraham W.T., Fisher W.G., Smith A.L., Delurgio D.B., Leon A.R., Loh E., Kocovic D.Z., Packer M., Clavell A.L., Hayes D.L., Ellestad M., Trupp R.J., Underwood J., Pickering F., Truex C., McAtee P., Messenger J., Cardiac resynchronization in chronic heart failure (MIRACLE study), N Engl J Med, 346, pp. 1845-1853, (2002)

[6]

Uchiyama T., Suga C., Matsumoto K., Kato R., Tosaka T., Yamaguchi T., Nagasaki H., Sakamoto A., Nishimura S., QRS width does not reveal the indication for biventricular pacemaker, Ther Res, 24, pp. 1516-1518, (2003)

[7]

Bax J.J., Ansalone G., Breithardt O.A., Derumeaux G., Leclercq C., Schalij M.J., Sogaard P., St. John Sutton M., Nihoyannopoulos P., Echocardiographic evaluation of cardiac resynchronization therapy: Ready for routine clinical use?, J Am Coll Cardiol, 44, pp. 1-9, (2004)

[8]

Porciani M.C., Puglisi A., Colella A., Peraldo C., Gaita F., Romano M., Pistis G., Curnis A., Sabini A., Musilli N., Padeletti L., Echocardiographic evaluation of the effect of biventricular pacing: The InSync Italian Registry, Eur Heart J Suppl, 2, pp. 23-30, (2000)

[9]

Rouleau F., Merheb M., Geffroy S., Berthelot J., Chaleil D., Dupuis J.M., Victor J., Geslin P., Echocardiographic assessment of the interventricular delay of activation and correlation to the QRS width in dilated cardiomyopathy, Pacing Clin Electrophysiol, 24, pp. 1500-1506, (2001)

[10]

Pitzalis M.V., Iacoviello M., Romito R., Massari F., Rizzon B., Luzzi G., Guida P., Andriani A., Mastropasqua F., Rizzon P., Cardiac resynchronization therapy tailored by echocardiographic evalution of ventricular asynchrony, J Am Coll Cardiol, 40, pp. 1615-1622, (2002)

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