Faculty Information |
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Article types | Original article |
Language | English |
Refereed paper | Refereed |
Title | Mechanical Dyssynchrony by Tissue Doppler Cross-Correlation is Associated with Risk for Complex Ventricular Arrhythmias after Cardiac Resynchronization Therapy. |
Journal | Formal name:Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography Abbreviation:J Am Soc Echocardiogr ISSN code:1097-6795(Electronic)0894-7317(Linking) |
Volume, Number, Page | 28(12),pp.1474-81 |
Papers・Author | Tayal Bhupendar, Gorcsan John, Delgado-Montero Antonia, Marek Josef J, Haugaa Kristina H, Ryo Keiko, Goda Akiko, Olsen Niels Thue, Saba Samir, Risum Niels, Sogaard Peter |
Publication date | 2015/12 |
Papers・Description | BACKGROUND:Tissue Doppler cross-correlation analysis has been shown to be associated with long-term survival after cardiac resynchronization defibrillator therapy (CRT-D). Its association with ventricular arrhythmia (VA) is unknown.METHODS:From two centers 151 CRT-D patients (New York Heart Association functMETHODS:ional classes II-IV, ejection fraction ≤ 35%, and QRS duration ≥ 120 msec) were prospectively included. Tissue Doppler cross-correlation analysis of myocardial acceleration curves from the basal segments in the apical views both at baseline and 6 months after CRT-D implantation was performed. Patients were divided into four subgroups on the basis of dyssynchrony at baseline and follow-up after CRT-D. Outcome events were predefined as appropriate antitachycardia pacing, shock, or death over 2 years.RESULTS:Mechanical dyssynchrony was present in 97 patients (64%) at baseline. At follow-up, 42 of these 97 patients (43%) had persistent dyssynchrony. Furthermore, among 54 patients with no dyssynchrony at baseline, 15 (28%) had onset of new dyssynchrony after CRT-D. In comparison with the group with reduced dyssynchrony, patients with persistent dyssynchrony after CRT-D were associated with a substantially increased risk for VA (hazard ratio [HRRESULTS:]RESULTS:, 4.4; 95% CI, 1.2-16.3; P = .03) and VA or death (HR, 4.0; 95% CI, 1.7-9.6; P = .002) after adjusting for other covariates. Similarly, patients with new dyssynchrony had increased risk for VA (HR, 10.6; 95% CI, 2.8-40.4; P = .001) and VA or death (HR, 5.0; 95% CI, 1.8-13.5; P = .002).CONCLUSIONS:Persistent and new mechanical dyssynchrony after CRT-D was associated with subsequent complex VA. Dyssynchrony after CRT-D is a marker of poor prognosis. |
DOI | 10.1016/j.echo.2015.07.021 |
PMID | 26342653 |