25 289

Cited 0 times in

The impact of exercise-induced changes in intraventricular dyssynchrony on functional improvement in patients with nonischemic cardiomyopathy.

Kang, SJ; Lim, HS; Choi, BJ; Choi, SY; Yoon, MH; Hwang, GS; Shin, JH; Tahk, SJ
Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 21(8):948-953, 2008
Journal Title
Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
BACKGROUND: The assessment of dynamic intraventricular dyssynchrony has been reported to be feasible in a clinical setting. However, its prognostic implication in functional improvement has not yet been investigated.

METHODS: Symptom-limited, supine bicycle exercise was performed on 41 patients with nonischemic cardiomyopathy (52 +/- 12 years, ejection fraction < 40%). Using Doppler tissue imaging, the average of peak systolic velocities at 6 basal segments was obtained at rest and peak exercise. Dyssynchrony index (Ts-SD12) was defined as the SD of the time to peak systolic velocities at 12 left ventricular segments. The percent change of end-systolic volume (%Delta ESV) was calculated at follow-up. A 15% or greater reduction in end-systolic volume (%Delta ESV < -15%) was considered as functional improvement.

RESULTS: During exercise, changes in dyssynchrony (Delta Ts-SD12) were individually variable. Average of peak systolic velocities (V) at 6 basal segments at peak exercise independently correlated with Ts-SD12 at peak exercise (beta = -0.541, P < .001). Follow-up echocardiography was performed on 35 patients after medical treatment for 13.0 +/- 4.9 months. There was significant association of %Delta ESV with the change in mitral regurgitation (r = 0.434, P = .009), disease duration (r = 0.343, P = .045), QRS interval (r = 0.347, P = .041), and Delta Ts-SD12 (r = 0.511, P = .002). Multivariate analysis identified Ts-SD12 measured at peak exercise as the strongest predictor for functional improvement (%Delta ESV: beta = 0.577, P < .001; and Delta ejection fraction: beta = -0.563, P < .001).

CONCLUSION: In patients with heart failure, dynamic dyssynchrony can be assessed during exercise. Ts-SD12 at peak exercise may be an independent predictor for reverse remodeling with medical treatment.
MeSH terms
Cardiomyopathies/ultrasonography*Echocardiography, Doppler/methods*Exercise Test/methods*FemaleHumansMaleMiddle AgedMyocardial Ischemia/ultrasonographyReproducibility of ResultsSensitivity and SpecificityVentricular Dysfunction, Left/ultrasonography*
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
AJOU Authors
강, 수진임, 홍석최, 병주최, 소연윤, 명호황, 교승신, 준한탁, 승제
Full Text Link
RIS (EndNote)
XLS (Excel)


해당 아이템을 이메일로 공유하기 원하시면 인증을 거치시기 바랍니다.

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.