期刊
HEART RHYTHM
卷 9, 期 12, 页码 2010-2015出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.hrthm.2012.08.031
关键词
Congenital heart defects; Dyssynchrony; Hypoplastic left heart syndrome; Pediatrics; Resynchronization
资金
- Lucile Packard Foundation for Children's Health (LPFCH)
- Stanford NIH CTSA [UL1 RR025744]
- Medtronic
BACKGROUND Cardiac resynchronization therapy has been proposed for treatment of hypoplastic left heart syndrome (HLHS) patients with right ventricular (RV) failure. The role of dyssynchrony, however, is poorly understood in this population. OBJECTIVE The purpose of this study was to better understand the relationship between electrical and mechanical dyssynchrony in HLHS using 3-dimensional electrical mapping, tissue Doppler indices of wall motion, and vector velocity imaging. METHODS Eleven HLHS subjects with normal RV function and ten normal subjects (age 3-18 years) were studied. Electrical and mechanical activation times and dyssynchrony indices (electrical dyssynchrony index, mechanical dyssynchrony index) were calculated using 3-dimensional electrical mapping, tissue Doppler indices, and vector velocity imaging. RESULTS No differences in measures of electrical dyssynchrony were seen when comparing HLHS patients and normal patients (electrical activation time 63.3 +/- 22.8 ms vs 56.2 +/- 11.2 ms, P = .38; electrical dyssynchrony index 13.7 +/- 6.3 ms vs 11.6 +/- 3.0 ms, P = .34). However, measures of mechanical dyssynchrony were markedly abnormal in HLHS patients despite normal RV function (mechanical activation time 16 +/- 11.3 ms vs 0.9 +/- 1.9 ms, P = .01; mechanical dyssynchrony index 7.5 +/- 5.5 vs 0.4 +/- 0.8, P <.01). CONCLUSION Patients with HLHS and preserved RV systolic function have normal electrical activation when compared to patients with normal right and left ventricles. In contrast, these patients demonstrate mechanical dyssynchrony compared to patients with normal right and left ventricles. This finding raises important questions about the indications for cardiac resynchronization therapy in this patient population.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据