| ǥ :
|
ȣ - 520541 166 |
| Differences in the left ventricular dyssynchrony index
in patients with left bundle branch block versus acute RV pacing: Assessment with 2D speckle tracking-derived radial strain |
| 서울대학교병원 순환기내과, 서울대학교 의과대학 내과학교실 |
| 박효은, 김형관, 최의근, 김용진, 오세일, 손대원, 오병희, 박영배, 최윤식 |
Background:Tissue velocity imaging has been used to calculate left ventricular dyssynchrony index (LVdys) in most previous works, but it has significant limitation as demonstrated in recent PROSPECT trial. The purpose of the present study is to evaluate differences in LVdys between acute RV pacing and LBBB patients using 2D speckle tracking-derived radial strain.Methods and Results:Total 34 subjects were enrolled with good echocardiography images; normal control (NL, n=13), individuals with LBBB (LBBB, n=8), and patients with acute RV pacing (RVP, n=13). On top of measure of conventional parameters, LVdys and maximum difference of time to peak strain were obtained. Results were shown in Table. On multivariate logistic regression analysis with 130 ms as a cutoff value for LVdys, LV end-diastolic volume (LVEDV) and S’emerged as independent determinants for LVdys.Conclusion:Higher proportion of LBBB showed LVdys > 130 ms than RVP. LV preload and contractility were independent determinants for LVdys presence.
|
|
Table. Comparison of data among the groups
|
|
NL (n=13) |
LBBB (n=8) |
RVP (n=13) |
|
Frame rate (fps) |
100±30 |
92±18 |
87± 13 |
|
Age (yrs) |
45±7 |
56±16 ‡ |
64±15 ‡ |
|
LVEDV (mL) |
106±15 |
140±43 ‡ |
135±31 ‡ |
|
LVESV (mL) |
35±9 |
59±27 ‡ |
47±24 |
|
LVEF by Simpson’s method |
67±6 |
53±3 ‡ |
54±12 ‡ |
|
E (m/s) |
0.64±0.15 |
0.7±0.18 |
0.58±0.21 |
|
A (m/s) |
0.5±0.15 |
0.85±0.17 |
0.8±0.23 ‡ |
|
DT (m/s) |
207±33 |
200±42 |
266±64 *‡ |
|
S’ (m/s) |
0.08±0.01 |
0.05±0.01 ‡ |
0.05±0.02 ‡ |
|
E/E’ ratio |
8.2±1.6 |
14.8±3.0 ‡ |
14.9±8.8 ‡ |
|
QRS duration (ms) |
95±9 |
152±25 ‡ |
168±22 †‡ |
|
LV end-systolic wall stress (g/cm2) |
231±59 |
220±39 |
218±34 |
|
LVdys (ms) |
50±54 |
181±138 ‡ |
99±72 †§ |
|
LVdys > 130 ms |
1 (7.7%) |
5 (62.5%) |
2 (15.4%) * |
* p < 0.05 vs LBBB, † p = 0.06 vs LBBB, ‡ p < 0.05 vs NL, § p = 0.06 vs NL
|
|
|
