Diastolic Asynchrony Is More Frequent Than Systolic Asynchrony in Dilated Cardiomyopathy and Is Less Improved by Cardiac Resynchronization Therapy

Diastolic Asynchrony Is More Frequent Than Systolic Asynchrony in Dilated Cardiomyopathy and Is Less Improved by Cardiac Resynchronization Therapy Iris Schuster, Gilbert Habib, Christophe Jego, Franck Thuny, Jean-François Avierinos, Geneviéve Derumeaux, Lionel Beck, Christine Medail, Frederic France...

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Veröffentlicht in:Journal of the American College of Cardiology 2005-12, Vol.46 (12), p.2250-2257
Hauptverfasser: Schuster, Iris, Habib, Gilbert, Jego, Christophe, Thuny, Franck, Avierinos, Jean-François, Derumeaux, Geneviève, Beck, Lionel, Medail, Christine, Franceschi, Frederic, Renard, Sebastien, Ferracci, Ange, Lefevre, Jean, Luccioni, Roger, Deharo, Jean-Claude, Djiane, Pierre
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container_issue 12
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container_title Journal of the American College of Cardiology
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creator Schuster, Iris
Habib, Gilbert
Jego, Christophe
Thuny, Franck
Avierinos, Jean-François
Derumeaux, Geneviève
Beck, Lionel
Medail, Christine
Franceschi, Frederic
Renard, Sebastien
Ferracci, Ange
Lefevre, Jean
Luccioni, Roger
Deharo, Jean-Claude
Djiane, Pierre
description Diastolic Asynchrony Is More Frequent Than Systolic Asynchrony in Dilated Cardiomyopathy and Is Less Improved by Cardiac Resynchronization Therapy Iris Schuster, Gilbert Habib, Christophe Jego, Franck Thuny, Jean-François Avierinos, Geneviéve Derumeaux, Lionel Beck, Christine Medail, Frederic Franceschi, Sebastien Renard, Ange Ferracci, Jean Lefevre, Roger Luccioni, Jean-Claude Deharo, Pierre Djiane To assess the role of diastolic asynchrony in patients with congestive heart failure (CHF), tissue Doppler imaging (TDI) was performed in 116 CHF patients. Among them, 42 underwent TDI studies before and after CRT. Diastolic asynchrony was more frequent than systolic (58% vs. 47%; p = 0.0004; for intraventricular; and 72% vs. 45%; p < 0.0001; for interventricular asynchrony). It was isolated in one-third of CHF patients and was weakly correlated with QRS duration. Diastolic intraventricular asynchrony decreased from 81% to 55% (p < 0.0002) after CRT, but was less improved than systolic asynchrony. To compare the incidence of diastolic and systolic asynchrony, assessed by tissue Doppler imaging (TDI), in patients with congestive heart failure (CHF) and severe left ventricular (LV) dysfunction, and to assess TDI changes induced by cardiac resynchronization therapy (CRT). Thirty percent of CRT candidates are nonresponders. Besides QRS width, the presence of echographic systolic asynchrony has been used to identify future responders. Little is known about diastolic asynchrony and its change after CRT. Tissue Doppler imaging was performed in 116 CHF patients (LV ejection fraction 26 ± 8%). Systolic and diastolic asynchrony was calculated using TDI recordings of right ventricular and LV walls. The CHF group consisted of 116 patients. Diastolic asynchrony was more frequent than systolic, concerning both intraventricular (58% vs. 47%; p = 0.0004) and interventricular (72 vs. 45%; p < 0.0001) asynchrony. Systolic and diastolic asynchrony were both present in 41% patients, but one-third had isolated diastolic asynchrony. Although diastolic delays increased with QRS duration, 42% patients with narrow QRS presented with diastolic asynchrony. Conversely, 27% patients with large QRS had no diastolic asynchrony. Forty-two patients underwent CRT. Incidence of systolic intraventricular asynchrony decreased from 71% to 33% after CRT (p < 0.0001), but diastolic asynchrony decreased only from 81% to 55% (p < 0.0002). Cardiac resynchronization therapy induced new diastolic asynchro
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Among them, 42 underwent TDI studies before and after CRT. Diastolic asynchrony was more frequent than systolic (58% vs. 47%; p = 0.0004; for intraventricular; and 72% vs. 45%; p &lt; 0.0001; for interventricular asynchrony). It was isolated in one-third of CHF patients and was weakly correlated with QRS duration. Diastolic intraventricular asynchrony decreased from 81% to 55% (p &lt; 0.0002) after CRT, but was less improved than systolic asynchrony. To compare the incidence of diastolic and systolic asynchrony, assessed by tissue Doppler imaging (TDI), in patients with congestive heart failure (CHF) and severe left ventricular (LV) dysfunction, and to assess TDI changes induced by cardiac resynchronization therapy (CRT). Thirty percent of CRT candidates are nonresponders. Besides QRS width, the presence of echographic systolic asynchrony has been used to identify future responders. Little is known about diastolic asynchrony and its change after CRT. Tissue Doppler imaging was performed in 116 CHF patients (LV ejection fraction 26 ± 8%). Systolic and diastolic asynchrony was calculated using TDI recordings of right ventricular and LV walls. The CHF group consisted of 116 patients. Diastolic asynchrony was more frequent than systolic, concerning both intraventricular (58% vs. 47%; p = 0.0004) and interventricular (72 vs. 45%; p &lt; 0.0001) asynchrony. Systolic and diastolic asynchrony were both present in 41% patients, but one-third had isolated diastolic asynchrony. Although diastolic delays increased with QRS duration, 42% patients with narrow QRS presented with diastolic asynchrony. Conversely, 27% patients with large QRS had no diastolic asynchrony. Forty-two patients underwent CRT. Incidence of systolic intraventricular asynchrony decreased from 71% to 33% after CRT (p &lt; 0.0001), but diastolic asynchrony decreased only from 81% to 55% (p &lt; 0.0002). Cardiac resynchronization therapy induced new diastolic asynchrony in eight patients. Diastolic asynchrony is weakly correlated with QRS duration, is more frequent than systolic asynchrony, and may be observed alone. Diastolic asynchrony is less improved by CRT than systolic. Persistent diastolic asynchrony may explain some cases of lack of improvement after CRT despite good systolic resynchronization.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/j.jacc.2005.02.096</identifier><identifier>PMID: 16360054</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Biological and medical sciences ; Bundle-Branch Block - etiology ; Bundle-Branch Block - therapy ; Cardiac arrhythmia ; Cardiac Pacing, Artificial - adverse effects ; Cardiology ; Cardiology. Vascular system ; Cardiomyopathy, Dilated - complications ; Diastole ; Drug therapy ; Echocardiography ; Electrocardiography ; Female ; Heart ; Heart attacks ; Heart Failure - complications ; Humans ; Male ; Medical sciences ; Middle Aged ; Myocarditis. Cardiomyopathies ; Prospective Studies ; Systole ; Treatment Outcome ; Ultrasonic imaging ; Ventricular Dysfunction - diagnosis ; Ventricular Dysfunction - etiology ; Ventricular Dysfunction - physiopathology ; Ventricular Dysfunction - therapy</subject><ispartof>Journal of the American College of Cardiology, 2005-12, Vol.46 (12), p.2250-2257</ispartof><rights>2005 American College of Cardiology Foundation</rights><rights>2006 INIST-CNRS</rights><rights>Copyright Elsevier Limited Dec 20, 2005</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c514t-e233722d45ac8b556506092c9306e65740b1ab05991fc93afe6cd2fe5bcc00143</citedby><cites>FETCH-LOGICAL-c514t-e233722d45ac8b556506092c9306e65740b1ab05991fc93afe6cd2fe5bcc00143</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jacc.2005.02.096$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=17385453$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16360054$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schuster, Iris</creatorcontrib><creatorcontrib>Habib, Gilbert</creatorcontrib><creatorcontrib>Jego, Christophe</creatorcontrib><creatorcontrib>Thuny, Franck</creatorcontrib><creatorcontrib>Avierinos, Jean-François</creatorcontrib><creatorcontrib>Derumeaux, Geneviève</creatorcontrib><creatorcontrib>Beck, Lionel</creatorcontrib><creatorcontrib>Medail, Christine</creatorcontrib><creatorcontrib>Franceschi, Frederic</creatorcontrib><creatorcontrib>Renard, Sebastien</creatorcontrib><creatorcontrib>Ferracci, Ange</creatorcontrib><creatorcontrib>Lefevre, Jean</creatorcontrib><creatorcontrib>Luccioni, Roger</creatorcontrib><creatorcontrib>Deharo, Jean-Claude</creatorcontrib><creatorcontrib>Djiane, Pierre</creatorcontrib><title>Diastolic Asynchrony Is More Frequent Than Systolic Asynchrony in Dilated Cardiomyopathy and Is Less Improved by Cardiac Resynchronization Therapy</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>Diastolic Asynchrony Is More Frequent Than Systolic Asynchrony in Dilated Cardiomyopathy and Is Less Improved by Cardiac Resynchronization Therapy Iris Schuster, Gilbert Habib, Christophe Jego, Franck Thuny, Jean-François Avierinos, Geneviéve Derumeaux, Lionel Beck, Christine Medail, Frederic Franceschi, Sebastien Renard, Ange Ferracci, Jean Lefevre, Roger Luccioni, Jean-Claude Deharo, Pierre Djiane To assess the role of diastolic asynchrony in patients with congestive heart failure (CHF), tissue Doppler imaging (TDI) was performed in 116 CHF patients. Among them, 42 underwent TDI studies before and after CRT. Diastolic asynchrony was more frequent than systolic (58% vs. 47%; p = 0.0004; for intraventricular; and 72% vs. 45%; p &lt; 0.0001; for interventricular asynchrony). It was isolated in one-third of CHF patients and was weakly correlated with QRS duration. Diastolic intraventricular asynchrony decreased from 81% to 55% (p &lt; 0.0002) after CRT, but was less improved than systolic asynchrony. To compare the incidence of diastolic and systolic asynchrony, assessed by tissue Doppler imaging (TDI), in patients with congestive heart failure (CHF) and severe left ventricular (LV) dysfunction, and to assess TDI changes induced by cardiac resynchronization therapy (CRT). Thirty percent of CRT candidates are nonresponders. Besides QRS width, the presence of echographic systolic asynchrony has been used to identify future responders. Little is known about diastolic asynchrony and its change after CRT. Tissue Doppler imaging was performed in 116 CHF patients (LV ejection fraction 26 ± 8%). Systolic and diastolic asynchrony was calculated using TDI recordings of right ventricular and LV walls. The CHF group consisted of 116 patients. Diastolic asynchrony was more frequent than systolic, concerning both intraventricular (58% vs. 47%; p = 0.0004) and interventricular (72 vs. 45%; p &lt; 0.0001) asynchrony. Systolic and diastolic asynchrony were both present in 41% patients, but one-third had isolated diastolic asynchrony. Although diastolic delays increased with QRS duration, 42% patients with narrow QRS presented with diastolic asynchrony. Conversely, 27% patients with large QRS had no diastolic asynchrony. Forty-two patients underwent CRT. Incidence of systolic intraventricular asynchrony decreased from 71% to 33% after CRT (p &lt; 0.0001), but diastolic asynchrony decreased only from 81% to 55% (p &lt; 0.0002). Cardiac resynchronization therapy induced new diastolic asynchrony in eight patients. Diastolic asynchrony is weakly correlated with QRS duration, is more frequent than systolic asynchrony, and may be observed alone. Diastolic asynchrony is less improved by CRT than systolic. Persistent diastolic asynchrony may explain some cases of lack of improvement after CRT despite good systolic resynchronization.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Bundle-Branch Block - etiology</subject><subject>Bundle-Branch Block - therapy</subject><subject>Cardiac arrhythmia</subject><subject>Cardiac Pacing, Artificial - adverse effects</subject><subject>Cardiology</subject><subject>Cardiology. 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Among them, 42 underwent TDI studies before and after CRT. Diastolic asynchrony was more frequent than systolic (58% vs. 47%; p = 0.0004; for intraventricular; and 72% vs. 45%; p &lt; 0.0001; for interventricular asynchrony). It was isolated in one-third of CHF patients and was weakly correlated with QRS duration. Diastolic intraventricular asynchrony decreased from 81% to 55% (p &lt; 0.0002) after CRT, but was less improved than systolic asynchrony. To compare the incidence of diastolic and systolic asynchrony, assessed by tissue Doppler imaging (TDI), in patients with congestive heart failure (CHF) and severe left ventricular (LV) dysfunction, and to assess TDI changes induced by cardiac resynchronization therapy (CRT). Thirty percent of CRT candidates are nonresponders. Besides QRS width, the presence of echographic systolic asynchrony has been used to identify future responders. Little is known about diastolic asynchrony and its change after CRT. Tissue Doppler imaging was performed in 116 CHF patients (LV ejection fraction 26 ± 8%). Systolic and diastolic asynchrony was calculated using TDI recordings of right ventricular and LV walls. The CHF group consisted of 116 patients. Diastolic asynchrony was more frequent than systolic, concerning both intraventricular (58% vs. 47%; p = 0.0004) and interventricular (72 vs. 45%; p &lt; 0.0001) asynchrony. Systolic and diastolic asynchrony were both present in 41% patients, but one-third had isolated diastolic asynchrony. Although diastolic delays increased with QRS duration, 42% patients with narrow QRS presented with diastolic asynchrony. Conversely, 27% patients with large QRS had no diastolic asynchrony. Forty-two patients underwent CRT. Incidence of systolic intraventricular asynchrony decreased from 71% to 33% after CRT (p &lt; 0.0001), but diastolic asynchrony decreased only from 81% to 55% (p &lt; 0.0002). Cardiac resynchronization therapy induced new diastolic asynchrony in eight patients. Diastolic asynchrony is weakly correlated with QRS duration, is more frequent than systolic asynchrony, and may be observed alone. Diastolic asynchrony is less improved by CRT than systolic. Persistent diastolic asynchrony may explain some cases of lack of improvement after CRT despite good systolic resynchronization.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>16360054</pmid><doi>10.1016/j.jacc.2005.02.096</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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subjects Aged
Biological and medical sciences
Bundle-Branch Block - etiology
Bundle-Branch Block - therapy
Cardiac arrhythmia
Cardiac Pacing, Artificial - adverse effects
Cardiology
Cardiology. Vascular system
Cardiomyopathy, Dilated - complications
Diastole
Drug therapy
Echocardiography
Electrocardiography
Female
Heart
Heart attacks
Heart Failure - complications
Humans
Male
Medical sciences
Middle Aged
Myocarditis. Cardiomyopathies
Prospective Studies
Systole
Treatment Outcome
Ultrasonic imaging
Ventricular Dysfunction - diagnosis
Ventricular Dysfunction - etiology
Ventricular Dysfunction - physiopathology
Ventricular Dysfunction - therapy
title Diastolic Asynchrony Is More Frequent Than Systolic Asynchrony in Dilated Cardiomyopathy and Is Less Improved by Cardiac Resynchronization Therapy
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