Asynergy and left ventricular performance in dilative cardiomyopathy.

Area of Science:

• Cardiology
• Biomedical Engineering
• Medical Imaging

Background:

• Dilative cardiomyopathy is characterized by impaired left ventricular function.
• Understanding the mechanisms of cardiac dysfunction is crucial for effective treatment.
• Asynergy, encompassing both asynchrony and hypokinesis, may play a significant role.

Purpose of the Study:

• To evaluate the presence and significance of asynergy in dilative cardiomyopathy.
• To quantify indices of asynchrony and hypokinesis.
• To correlate these indices with overall left ventricular function.

Main Methods:

• Semiautomated analysis of left ventriculograms in 18 dilative cardiomyopathy patients.
• Evaluation of longitudinal and transverse axes time-length curves.
• Comparison with 10 normal subjects and 9 patients with aortic regurgitation.

Main Results:

• Anomalous (polyphasic) time-length curves observed in 55% of dilative cardiomyopathy cases.
• Significantly increased hypokinesis index (28.8% vs. 17.8%) and slightly increased asynchrony index in dilative cardiomyopathy.
• Negative correlation between asynchrony index and ejection fraction (r = -0.483).
• Reduced ejection fraction and contraction velocity in patients with anomalous curves.

Conclusions:

• Asynergy, particularly asynchrony, is frequent in dilative cardiomyopathy.
• Asynergy is strongly associated with significant impairment of left ventricular function.
• These findings highlight the importance of assessing cardiac asynergy in dilative cardiomyopathy.