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Dynamic ventricular dyssynchrony: an exercise-echocardiography study.

Stephane Lafitte1, Pierre Bordachar, Marianne Lafitte

  • 1Cardiologic Hospital, Pessac and Bordeaux 2 University, Bordeaux, France.

Journal of the American College of Cardiology
|June 6, 2006
PubMed
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Exercise can alter ventricular dyssynchrony in heart failure patients, with some experiencing induced or normalized dyssynchrony during exertion. These changes impact cardiac output and mitral regurgitation.

Area of Science:

  • Cardiology
  • Cardiac Electrophysiology
  • Exercise Physiology

Background:

  • Ventricular dyssynchrony negatively impacts cardiac function and prognosis in heart failure.
  • Exercise-induced changes in dyssynchrony may influence dynamic cardiac output and mitral regurgitation.

Purpose of the Study:

  • To evaluate the impact of exercise on left ventricular (LV) dyssynchrony in patients with normal and reduced LV function.
  • To determine if exercise can induce or normalize ventricular dyssynchrony in heart failure patients.

Main Methods:

  • Exercise echocardiography was performed on 65 heart failure patients and 50 healthy controls.
  • Conventional and tissue Doppler parameters were measured pre- and during exercise.
  • LV dyssynchrony was quantified using the standard deviation of 12 LV segmental electromechanical delays.

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Main Results:

  • Exercise did not alter LV asynchrony in patients with normal LV function.
  • In heart failure patients, LV dyssynchrony increased in 34%, remained stable in 37%, and decreased in 29% during exercise.
  • Exercise-induced dyssynchrony changes correlated with ischemic cardiomyopathy, cardiac output, and mitral regurgitation.

Conclusions:

  • Exercise can modify the degree of ventricular dyssynchrony in heart failure.
  • Some heart failure patients exhibit exercise-induced dyssynchrony, while others show normalization.
  • Changes in ventricular dyssynchrony during exercise are linked to alterations in cardiac output and mitral regurgitation.