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We assessed the relationship of left atrial (LA) synchronicity to left ventricular (LV) diastolic function in non-ischemic dilated cardiomyopathy (DCM) with and without left bundle branch block (LBBB).
Consecutive 80 patients with non-ischemic DCM (LVEF < 35%) were enrolled. LV systolic synchronicity (D-Ts) and diastolic synchronicity (D-Te) were defined using the time difference between the shortest and longest delay between the onset of QRS complex and peak of systolic velocity and peak of early diastolic velocity among the 4 LV walls. LA synchronicity (D-Ta) was defined using the time difference between the shortest and longest delay between the onset of P wave and peak of atrial velocity among the 4 LA walls.
There was no significant difference of LV size, LVEF and LA volume between LBBB (n = 38) and no LBBB (n = 42). There was a significant difference of D-Ts between LBBB and no LBBB (p = 0.024), and was a mild difference of LV diastolic synchronicity between LBBB and no LBBB (p = 0.045). However, there was no difference of D-Ta between LBBB and no LBBB (p = 0.61). D-Ta was related to the deceleration time of mitral early diastolic velocity (E) (r = −0.249, p = 0.04) and the ratio of E to mitral annular early diastolic velocity (r = 0.344, p = 0.02). D-Ta was also mildly related to LA volume (r = 0.215, p = 0.046).
LA synchronicity was related to LV diastolic function regardless of the presence of LBBB in patients with non-ischemic DCM.
|With LBBB (n = 38)||With no LBBB (n = 42)||P-value|
|Duration of QRS complex, ms||168.3 ± 17.9||93.8 ± 14.5||<0.001|
|LV end-diastolic volume, ml/m2||111.7 ± 16.8||106.0 ± 13.7||0.312|
|LV ejection fraction (EF), %||24.6 ± 6.3||23.3 ± 7.2||0.295|
|LA volume, ml/m2||41.5 ± 14.4||44.2 ± 18.8||0.452|
|Deceleration time of E, ms||200.6 ± 77.4||186.8 ± 67.4||0.216|
|E/e'||19.6 ± 10.2||21.4 ± 7.8||0.570|
|D-Ts, ms||67.5 ± 46.7||36.5 ± 31.9||0.024|
|D-Te, ms||57.5 ± 41.0||50.0 ± 36.6||0.045|
|D-Ta, ms||19.5 ± 12.7||22.1 ± 17.7||0.610|
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Imaging: Echo IX
Abstract Category: 18. Imaging: Echo
Presentation Number: 1227-341
- 2013 American College of Cardiology Foundation