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Effect of intraventricular dyssynchrony on diastolic function and exercise tolerance in patients with heart failure

Quirino Ciampi1, Bruno Petruzziello, Michele Della Porta

  • 1Division of Cardiology, Fatebenefratelli Hospital, Viale Principe di Napoli, 12, I-82100 Benevento, Italy. qciampi@iol.it

European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology
|July 16, 2009
PubMed

Insights

Intraventricular dyssynchrony in congestive heart failure (CHF) patients correlates with worse outcomes and predicts reduced exercise capacity. This finding aids in the functional assessment of CHF patients.

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Exercise Physiology

Background:

  • Intraventricular dyssynchrony may worsen congestive heart failure (CHF) severity.
  • Assessing dyssynchrony correlates and its predictive value for exercise intolerance is crucial in CHF management.

Purpose of the Study:

  • To evaluate the correlates of intraventricular dyssynchrony in CHF patients.
  • To determine if intraventricular dyssynchrony independently predicts exercise intolerance.

Main Methods:

  • Eighty-one CHF patients underwent cardiopulmonary exercise testing.
  • Left ventricular diastolic function was assessed using transmitral patterns and tissue Doppler.
  • Intraventricular dyssynchrony was measured by time intervals between QRS onset and systolic velocities of basal septum and lateral wall.

Main Results:

  • Patients with intraventricular dyssynchrony (>40 ms) exhibited higher NYHA class, elevated BNP, more restrictive transmitral patterns, and higher E/E(a) compared to those without dyssynchrony.
  • Higher intraventricular dyssynchrony was associated with lower mitral annulus peak systolic velocity and significantly reduced peak oxygen consumption.
  • Independent predictors of exercise tolerance included intraventricular dyssynchrony, log BNP, and E/E(a).

Conclusions:

  • Intraventricular dyssynchrony is linked to elevated left ventricular filling pressures and reduced ejection fraction.
  • Intraventricular dyssynchrony serves as an independent predictor of diminished aerobic capacity in CHF patients.
  • Measuring intraventricular dyssynchrony can be valuable for the functional evaluation of patients with congestive heart failure.
Abstract

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