Association between right ventricular systolic function and electromechanical delay in patients with right bundle branch block

Abstract Background Elevated right ventricle (RV) pressure and/or volume can place stress on the right bundle branch block (RBBB) and its associated Purkinje network, which can affect its electrical properties, resulting in conduction delay or block. We hypothesized that prolonged R′ wave duration i...

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Veröffentlicht in:Journal of cardiology 2017-11, Vol.70 (5), p.470-475
Hauptverfasser: Park, Dong Hyun, MD, Cho, Kyoung Im, MD, PhD, Kim, Yoon Kyung, MD, Kim, Bong Joon, MD, You, Ga In, MD, Im, Sung Il, MD, Kim, Hyun Su, MD, Heo, Jeong Ho, MD, PhD
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container_end_page 475
container_issue 5
container_start_page 470
container_title Journal of cardiology
container_volume 70
creator Park, Dong Hyun, MD
Cho, Kyoung Im, MD, PhD
Kim, Yoon Kyung, MD
Kim, Bong Joon, MD
You, Ga In, MD
Im, Sung Il, MD
Kim, Hyun Su, MD
Heo, Jeong Ho, MD, PhD
description Abstract Background Elevated right ventricle (RV) pressure and/or volume can place stress on the right bundle branch block (RBBB) and its associated Purkinje network, which can affect its electrical properties, resulting in conduction delay or block. We hypothesized that prolonged R′ wave duration in lead V1 would extend the later portion of the QRS complex and can act as an indicator of reduced RV function in patients with RBBB. Method Kosin University Gospel Hospital echocardiography and electrocardiography (ECG) database was reviewed to identify patients with complete RBBB between 2013 and 2015. ECGs recorded closest to the time of the echocardiography were carefully reviewed, and QRS and R′ wave duration were measured. RV systolic dysfunction was defined as an RV fractional area change (FAC) less than 35%, as indicated by echocardiography guidelines. Results Compared to patients with normal RV function ( n = 241), patients with RV dysfunction ( n = 123) showed prolonged QRS duration (145.3 ± 19.3 ms vs. 132.2 ± 13.4 ms, p < 0.001), predominantly due to R′ prolongation (84.8 ± 13.0 ms vs. 102.9 ± 12.0 ms, p < 0.001). R′ duration was significantly associated with RV FAC ( r = −0.609, p < 0.001), RV systolic pressure ( r = 0.142, p = 0.008), RV dimension ( r = 0.193, p < 0.001), and RV myocardial performance index ( r = 0.199, p < 0.001). On receiving operator characteristic curve analysis, V1 R′ duration ≥93 ms was associated with RV dysfunction with 90% sensitivity and 87% specificity (area under the curve: 0.883, 95% confidence interval = 0.845–0.914, p < 0.001). Conclusion Prolonged R′ wave duration in lead V1 is an indicator of RV dysfunction and pressure and/or volume overload in patients with RBBB.
doi_str_mv 10.1016/j.jjcc.2017.01.004
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We hypothesized that prolonged R′ wave duration in lead V1 would extend the later portion of the QRS complex and can act as an indicator of reduced RV function in patients with RBBB. Method Kosin University Gospel Hospital echocardiography and electrocardiography (ECG) database was reviewed to identify patients with complete RBBB between 2013 and 2015. ECGs recorded closest to the time of the echocardiography were carefully reviewed, and QRS and R′ wave duration were measured. RV systolic dysfunction was defined as an RV fractional area change (FAC) less than 35%, as indicated by echocardiography guidelines. Results Compared to patients with normal RV function ( n = 241), patients with RV dysfunction ( n = 123) showed prolonged QRS duration (145.3 ± 19.3 ms vs. 132.2 ± 13.4 ms, p < 0.001), predominantly due to R′ prolongation (84.8 ± 13.0 ms vs. 102.9 ± 12.0 ms, p < 0.001). R′ duration was significantly associated with RV FAC ( r = −0.609, p < 0.001), RV systolic pressure ( r = 0.142, p = 0.008), RV dimension ( r = 0.193, p < 0.001), and RV myocardial performance index ( r = 0.199, p < 0.001). On receiving operator characteristic curve analysis, V1 R′ duration ≥93 ms was associated with RV dysfunction with 90% sensitivity and 87% specificity (area under the curve: 0.883, 95% confidence interval = 0.845–0.914, p < 0.001). Conclusion Prolonged R′ wave duration in lead V1 is an indicator of RV dysfunction and pressure and/or volume overload in patients with RBBB.]]></description><identifier>ISSN: 0914-5087</identifier><identifier>EISSN: 1876-4738</identifier><identifier>DOI: 10.1016/j.jjcc.2017.01.004</identifier><identifier>PMID: 28238566</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Aged ; Bundle-Branch Block - diagnostic imaging ; Bundle-Branch Block - physiopathology ; Cardiac function ; Cardiovascular ; Conduction delay ; Echocardiography ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Right ventricle ; Systole ; Ventricular Function, Right</subject><ispartof>Journal of cardiology, 2017-11, Vol.70 (5), p.470-475</ispartof><rights>2017 Japanese College of Cardiology</rights><rights>Copyright © 2017 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c479t-8c820b060090d66d45977b2d0e81a684ca3992a1338848ef539342b22fb9b08a3</citedby><cites>FETCH-LOGICAL-c479t-8c820b060090d66d45977b2d0e81a684ca3992a1338848ef539342b22fb9b08a3</cites><orcidid>0000-0003-3137-0218</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jjcc.2017.01.004$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28238566$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Park, Dong Hyun, MD</creatorcontrib><creatorcontrib>Cho, Kyoung Im, MD, PhD</creatorcontrib><creatorcontrib>Kim, Yoon Kyung, MD</creatorcontrib><creatorcontrib>Kim, Bong Joon, MD</creatorcontrib><creatorcontrib>You, Ga In, MD</creatorcontrib><creatorcontrib>Im, Sung Il, MD</creatorcontrib><creatorcontrib>Kim, Hyun Su, MD</creatorcontrib><creatorcontrib>Heo, Jeong Ho, MD, PhD</creatorcontrib><title>Association between right ventricular systolic function and electromechanical delay in patients with right bundle branch block</title><title>Journal of cardiology</title><addtitle>J Cardiol</addtitle><description><![CDATA[Abstract Background Elevated right ventricle (RV) pressure and/or volume can place stress on the right bundle branch block (RBBB) and its associated Purkinje network, which can affect its electrical properties, resulting in conduction delay or block. We hypothesized that prolonged R′ wave duration in lead V1 would extend the later portion of the QRS complex and can act as an indicator of reduced RV function in patients with RBBB. Method Kosin University Gospel Hospital echocardiography and electrocardiography (ECG) database was reviewed to identify patients with complete RBBB between 2013 and 2015. ECGs recorded closest to the time of the echocardiography were carefully reviewed, and QRS and R′ wave duration were measured. RV systolic dysfunction was defined as an RV fractional area change (FAC) less than 35%, as indicated by echocardiography guidelines. Results Compared to patients with normal RV function ( n = 241), patients with RV dysfunction ( n = 123) showed prolonged QRS duration (145.3 ± 19.3 ms vs. 132.2 ± 13.4 ms, p < 0.001), predominantly due to R′ prolongation (84.8 ± 13.0 ms vs. 102.9 ± 12.0 ms, p < 0.001). R′ duration was significantly associated with RV FAC ( r = −0.609, p < 0.001), RV systolic pressure ( r = 0.142, p = 0.008), RV dimension ( r = 0.193, p < 0.001), and RV myocardial performance index ( r = 0.199, p < 0.001). On receiving operator characteristic curve analysis, V1 R′ duration ≥93 ms was associated with RV dysfunction with 90% sensitivity and 87% specificity (area under the curve: 0.883, 95% confidence interval = 0.845–0.914, p < 0.001). Conclusion Prolonged R′ wave duration in lead V1 is an indicator of RV dysfunction and pressure and/or volume overload in patients with RBBB.]]></description><subject>Aged</subject><subject>Bundle-Branch Block - diagnostic imaging</subject><subject>Bundle-Branch Block - physiopathology</subject><subject>Cardiac function</subject><subject>Cardiovascular</subject><subject>Conduction delay</subject><subject>Echocardiography</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Right ventricle</subject><subject>Systole</subject><subject>Ventricular Function, Right</subject><issn>0914-5087</issn><issn>1876-4738</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kT1vFDEQhi0EIkfgD1AglzS7jO398EoIKYr4kiJRALVle-c4b3z2Ye8muobfjjd3UFBQuXned8bPEPKSQc2AdW-mepqsrTmwvgZWAzSPyIbJvquaXsjHZAMDa6oWZH9BnuU8AXQwyO4pueCSC9l23Yb8uso5WqdnFwM1ON8jBprcj91M7zDMydnF60TzMc_RO0u3S7APrA4jRY92TnGPdqeDs9rTEb0-UhfooTSWfKb3bt6dC80SRo_UJB3sjhof7e1z8mSrfcYX5_eSfP_w_tv1p-rmy8fP11c3lW36Ya6klRxMWR8GGLtubNqh7w0fASXTnWysFsPANRNCykbithWDaLjhfGsGA1KLS_L61HtI8eeCeVZ7ly16rwPGJatijbeSc9EXlJ9Qm2LOCbfqkNxep6NioFbvalKrd7V6V8BU8V5Cr879i9nj-DfyR3QB3p4ALL-8c5hUtkWQxdGlIlGN0f2__90_cevdg_JbPGKe4pJC8aeYylyB-rpefj086wUAL_N_A9wiqpw</recordid><startdate>20171101</startdate><enddate>20171101</enddate><creator>Park, Dong Hyun, MD</creator><creator>Cho, Kyoung Im, MD, PhD</creator><creator>Kim, Yoon Kyung, MD</creator><creator>Kim, Bong Joon, MD</creator><creator>You, Ga In, MD</creator><creator>Im, Sung Il, MD</creator><creator>Kim, Hyun Su, MD</creator><creator>Heo, Jeong Ho, MD, PhD</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3137-0218</orcidid></search><sort><creationdate>20171101</creationdate><title>Association between right ventricular systolic function and electromechanical delay in patients with right bundle branch block</title><author>Park, Dong Hyun, MD ; Cho, Kyoung Im, MD, PhD ; Kim, Yoon Kyung, MD ; Kim, Bong Joon, MD ; You, Ga In, MD ; Im, Sung Il, MD ; Kim, Hyun Su, MD ; Heo, Jeong Ho, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c479t-8c820b060090d66d45977b2d0e81a684ca3992a1338848ef539342b22fb9b08a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Bundle-Branch Block - diagnostic imaging</topic><topic>Bundle-Branch Block - physiopathology</topic><topic>Cardiac function</topic><topic>Cardiovascular</topic><topic>Conduction delay</topic><topic>Echocardiography</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Right ventricle</topic><topic>Systole</topic><topic>Ventricular Function, Right</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Park, Dong Hyun, MD</creatorcontrib><creatorcontrib>Cho, Kyoung Im, MD, PhD</creatorcontrib><creatorcontrib>Kim, Yoon Kyung, MD</creatorcontrib><creatorcontrib>Kim, Bong Joon, MD</creatorcontrib><creatorcontrib>You, Ga In, MD</creatorcontrib><creatorcontrib>Im, Sung Il, MD</creatorcontrib><creatorcontrib>Kim, Hyun Su, MD</creatorcontrib><creatorcontrib>Heo, Jeong Ho, MD, PhD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Park, Dong Hyun, MD</au><au>Cho, Kyoung Im, MD, PhD</au><au>Kim, Yoon Kyung, MD</au><au>Kim, Bong Joon, MD</au><au>You, Ga In, MD</au><au>Im, Sung Il, MD</au><au>Kim, Hyun Su, MD</au><au>Heo, Jeong Ho, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association between right ventricular systolic function and electromechanical delay in patients with right bundle branch block</atitle><jtitle>Journal of cardiology</jtitle><addtitle>J Cardiol</addtitle><date>2017-11-01</date><risdate>2017</risdate><volume>70</volume><issue>5</issue><spage>470</spage><epage>475</epage><pages>470-475</pages><issn>0914-5087</issn><eissn>1876-4738</eissn><abstract><![CDATA[Abstract Background Elevated right ventricle (RV) pressure and/or volume can place stress on the right bundle branch block (RBBB) and its associated Purkinje network, which can affect its electrical properties, resulting in conduction delay or block. We hypothesized that prolonged R′ wave duration in lead V1 would extend the later portion of the QRS complex and can act as an indicator of reduced RV function in patients with RBBB. Method Kosin University Gospel Hospital echocardiography and electrocardiography (ECG) database was reviewed to identify patients with complete RBBB between 2013 and 2015. ECGs recorded closest to the time of the echocardiography were carefully reviewed, and QRS and R′ wave duration were measured. RV systolic dysfunction was defined as an RV fractional area change (FAC) less than 35%, as indicated by echocardiography guidelines. Results Compared to patients with normal RV function ( n = 241), patients with RV dysfunction ( n = 123) showed prolonged QRS duration (145.3 ± 19.3 ms vs. 132.2 ± 13.4 ms, p < 0.001), predominantly due to R′ prolongation (84.8 ± 13.0 ms vs. 102.9 ± 12.0 ms, p < 0.001). R′ duration was significantly associated with RV FAC ( r = −0.609, p < 0.001), RV systolic pressure ( r = 0.142, p = 0.008), RV dimension ( r = 0.193, p < 0.001), and RV myocardial performance index ( r = 0.199, p < 0.001). On receiving operator characteristic curve analysis, V1 R′ duration ≥93 ms was associated with RV dysfunction with 90% sensitivity and 87% specificity (area under the curve: 0.883, 95% confidence interval = 0.845–0.914, p < 0.001). Conclusion Prolonged R′ wave duration in lead V1 is an indicator of RV dysfunction and pressure and/or volume overload in patients with RBBB.]]></abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>28238566</pmid><doi>10.1016/j.jjcc.2017.01.004</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-3137-0218</orcidid><oa>free_for_read</oa></addata></record>
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subjects Aged
Bundle-Branch Block - diagnostic imaging
Bundle-Branch Block - physiopathology
Cardiac function
Cardiovascular
Conduction delay
Echocardiography
Electrocardiography
Female
Humans
Male
Middle Aged
Right ventricle
Systole
Ventricular Function, Right
title Association between right ventricular systolic function and electromechanical delay in patients with right bundle branch block
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