Systolic and diastolic intraventricular asynchrony of the left ventricular myocardium in patients with pacemaker
- Authors: At'kov O.Y.1, Popova E.Y.2, Gorokhova S.G.3, Atkov OY.4, Popova EY.5, Gorokhova SG6
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Affiliations:
- МБФ ГОУ ВПО РГМУ им. Н. И. Пирогова
- НУЗ Центральная клиническая больница № 2 им. Н. А.Семашко ОАО РЖД
- ГБОУ ВПО Первый московский государственный медицинский университет им. И. М. Сеченова
- N.I. Pirogov Russian Medical University, Moscow
- N.A. Semashko central hospital N 2, Moscow
- I.M. Sechenov First Moscow Medical University, Moscow
- Issue: Vol 84, No 1 (2012)
- Pages: 36-40
- Section: Editorial
- URL: https://journals.rcsi.science/0040-3660/article/view/30978
- ID: 30978
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Abstract
Material and methods. The study of 46 patients with cardiac arrhythmia (atrial fibrillation, sick sinus syndrome, AB-block of the third degree) included such examinations as echocardiography, tissue dopplerography (PWTDI) before pacemaker implantation and 7 days after it. Electromechanic systolic and diastolic myocardial asynchrony was assessed by intraventricular heterogeneity index (IHb, IHm, TSD) in 8 segments of the left ventricle (LV) at the basal and mean levels. Values obtained in examination of 32 healthy volunteers were considered normal.
Results. Parameters of systolic and diastolic asynchrony in patients with cardiac arrhythmia significantly differ from normal ones. Basal LV diastolic asynchrony was detected in 41-48% patients, systolic one - in 62-100%, systolodiastolic - in 41% cases. Pacemaker implantation into the right heart significantly reduces LV systolic asynchrony while diastolic one was unaffected in an early postoperative period. The best sensitivity in detection of systolic asynchrony is achieved with TsSD index. Informative value of diastolic asynchrony parameters is much less than of the systolic one.
Conclusion. Indices of systolic asynchrony (TsSD, IhbS, IhmS) can be used for heart condition control after pacemaker implantation.
About the authors
Oleg Yur'evich At'kov
МБФ ГОУ ВПО РГМУ им. Н. И. Пироговад-р мед. наук, проф., зав. каф. инструментальных методов диагностики МБФ ГБОУ ВПО Российский национальный медицинский университет им. Н. И. Пирогова Минздравсоцразвития России; МБФ ГОУ ВПО РГМУ им. Н. И. Пирогова
Elena Yur'evna Popova
НУЗ Центральная клиническая больница № 2 им. Н. А.Семашко ОАО РЖДврач функциональной диагностики НУЗ Центральная клиническая больница № 2 им. Н. А. Семашко ОАО РЖД; НУЗ Центральная клиническая больница № 2 им. Н. А.Семашко ОАО РЖД
Svetlana Georgievna Gorokhova
ГБОУ ВПО Первый московский государственный медицинский университет им. И. М. Сеченова
Email: cafedra2004@mail.ru
д-р мед. наук, проф. каф. семейной медицины ФППОВ ГБОУ ВПО Первый московский государственный медицинский университет им. И. М. Сеченова Минздравсоцразвития России; ГБОУ ВПО Первый московский государственный медицинский университет им. И. М. Сеченова
O Yu Atkov
N.I. Pirogov Russian Medical University, MoscowN.I. Pirogov Russian Medical University, Moscow
E Yu Popova
N.A. Semashko central hospital N 2, MoscowN.A. Semashko central hospital N 2, Moscow
S G Gorokhova
I.M. Sechenov First Moscow Medical University, MoscowI.M. Sechenov First Moscow Medical University, Moscow
References
- Kim J. H., Jang H. S., Bae B. S. et al. Left ventricular dyssynchrony in patients showing diastolic dysfunction without overt symptoms of heart failure. Korean J. Intern. Med. 2010; 25 (3): 246-252.
- Hansen A., Haass M., Zugck C. et al. Prognostic value of Doppler echocardiographic mitral inflow patterns: implications for risk stratification in patients with chronic congestive heart failure. J. Am. Coll. Cardiol. 2001; 37: 1049-1055.
- Kass D. A., Chen C. H., Curry C. et al. Improved left ventricular mechanics from acute VDD pacing in patients with dilated cardiomyopathy and ventricular conduction delay. Circulation 1999; 99: 1567-1573.
- Schuster I., Habib G., Jego C. et al. Diastolic asynchrony is more frequent than systolic asynchrony in dilated cardiomyopathy and is less improved by cardiac resynchronization therapy. J. Am. Coll. Cardiol. 2005; 46: 2250-2257.
- Wang J., Kurrelmeyer K. M., Torre-Amione G., Nagueh S. F. Systolic and diastolic dyssynchrony in patients with diastolic heart failure and the effect of medical therapy. J. Am. Coll. Cardiol. 2007; 49: 88-96.
- Xie G. Y., Berk M. R., Smith M. D. et al. Prognostic value of Doppler transmitral flow patterns in patients with congestive heart failure. J. Am. Coll. Cardiol. 1994; 24: 132-139.
- Yu C. M., Lin H., Zhang Q., Sanderson J. E. High prevalence of left ventricular systolic and diastolic asynchrony in patients with congestive heart failure and normal QRS duration. Heart 2003; 89: 54-60.
- Yu C. M., Zhang Q., Yip G. W. et al. Diastolic and systolic asynchrony in patients with diastolic heart failure: a common but ignored condition. J. Am. Coll. Cardiol. 2007; 49: 97-105.
- Rovner A., de Las Fuentes L., Faddis M. N. et al. Relation of left ventricular lead placement in cardiac resynchronization therapy to left ventricular reverse remodeling and to diastolic dyssynchrony. Am. J. Cardiol. 2007; 99 (2): 239-241.
- Shanks M., Bertini M., Delgado V. et al. Effect of biventricular pacing on diastolic dyssynchrony. J. Am. Coll. Cardiol. 2010; 56 (19): 1567-1575.
- Попова Е. Ю., Баранович В. Ю., Горохова С. Г. и др. Влияние электрокардиостимуляторов различного типа на электромеханическое сопряжение миокарда при лечении нарушений ритма сердца. Клин. геронтол. 2010; 5: 16-21.
- Friedberg M. K., Roche S. L., Mohammed A. F. et al. Left ventricular diastolic mechanical dyssynchrony and associated clinical outcomes in children with dilated cardiomyopathy. Circ. Cardiovasc. Imag. 2008; 1: 50-57/
- Chang S. A., Kim H. K., Kim D. H. et al. Left ventricular systolic and diastolic dyssynchrony in asymptomatic hypertensive patients. J. Am. Soc. Echocardiogr. 2009; 22 (4): 337-342.
- Dwivedi S. K., Bansal S., Puri A. et al. Diastolic and systolic right ventricular dysfunction precedes left ventricular dysfunction in patients paced from right ventricular apex. Ind. Pacing Electrophys. J. 2006; 6 (3): 142-152.
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