INCIDENCE OF MORTALITY IN 1,040 PATIENTS WITH CARDIOVASCULAR DISEASE WITH NORMAL AND ABNORMAL QRS DURATION AND WITH NORMAL AND ABNORMAL LEFT VENTRICULAR EJECTION FRACTION

CHEST Journal ◽  
2008 ◽  
Vol 134 (4) ◽  
pp. 2P ◽  
Author(s):  
Hoang M. Lai ◽  
Wilbert S. Aronow ◽  
Archana Rajdev ◽  
Amit Asija ◽  
Khanh V. Lai ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Qrs Duration

scholarly journals Increased QRS duration and dispersion are associated with mechanical dyssynchrony in patients with permanent right ventricular apical pacing

Discoveries ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. e128
Author(s):  
Elibet Chávez-González ◽  
◽  
Arian Nodarse-Concepción ◽  
Ionuț Donoiu ◽  
Fernando Rodríguez-González ◽  
...  
Keyword(s):  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Mechanical Dyssynchrony ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Qrs Duration ◽  
Right Ventricular Apical Pacing

Background: Permanent right ventricular apical pacing may have negative effects on ventricular function and contribute to development of heart failure. We aimed to assess intra- and interventricular mechanical dyssynchrony in patients with permanent right ventricular apical pacing, and to establish electrocardiographic markers of dyssynchrony. Methods: 84 patients (46:38 male:female) who required permanent pacing were studied. Pacing was done from right ventricular apex in all patients. We measured QRS duration and dispersion on standard 12-lead ECG. Intra- and interventricular mechanical dyssynchrony and left ventricular ejection fraction were assessed by transthoracic echocardiography. Patients were followed-up for 24 months. Results: Six months after implantation, QRS duration increased from 128.02 ms to 132.40 ms, p≤0.05. At 24 months, QRS dispersion increased from 43.26 ms to 46.13 ms, p≤0.05. Intra- and interventricular dyssynchrony increased and left ventricular ejection fraction decreased during follow-up. A QRS dispersion of 47 ms predicted left ventricular dysfunction and long-term electromechanical dyssynchrony with a sensitivity of 80% and a specificity of 76%. Conclusion: In patients with permanent right ventricular apical pacing there is an increased duration and dispersion of QRS related to dyssynchrony and decreased left ventricular ejection fraction. This study shows that QRS dispersion could be a better predictive variable than QRS duration for identifying left ventricular ejection fraction worsening in patients with permanent right ventricular apical pacing. The electrocardiogram is a simple tool for predicting systolic function worsening in these patients and can be used at the bedside for early diagnosis in the absence of clinical symptoms, allowing adjustments of medical treatment to prevent progression of heart failure and improve the patient's quality of life.

Influence of baseline QRS on the left ventricular ejection fraction recovery after frequent premature ventricular complex ablation

EP Europace ◽  
2020 ◽  
Vol 22 (2) ◽  
pp. 274-280 ◽  
Author(s):  
Diego Penela ◽  
Beatriz Jáuregui ◽  
Juan Fernández-Armenta ◽  
Luis Aguinaga ◽  
Luis Tercedor ◽  
...  
Keyword(s):  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Premature Ventricular Complex ◽  
Ventricular Ejection Fraction ◽  
Qrs Duration

Abstract Aims Frequent premature ventricular complexes (PVCs) can induce or worsen left ventricular systolic dysfunction. We aimed to investigate the influence of the baseline QRS in the response after PVC ablation in patients with depressed left ventricular ejection fraction (LVEF). Methods and results Two hundred and fifteen [59 ± 13 years old, 152 (71%) men] consecutive patients with left ventricular (LV) systolic dysfunction and frequent PVCs referred for ablation were included and followed-up for 12 months. Echocardiographic response was defined as an improvement of at least five absolute points in LVEF. Clinical, electrocardiogram, and electrophysiological characteristics were analysed. Mean baseline QRS duration was 110 ms [97–140]. Premature ventricular complex burden significantly decreased after ablation from 23% [16–33] at baseline to 1% [0–8] at 12 months, P < 0.001. Mean PVC burden reduction was 18 [8–30] points. There was a significant improvement of LVEF from 35% [29–40] at baseline to 44% [35–55] at 12 months, P < 0.001. One hundred and thirty (61%) patients were considered as echocardiographic responders. Baseline QRS duration (ms) [odds ratio (OR) 0.98 (0.97–0.99), P = 0.01] was an independent predictor of echocardiographic response. Mean LVEF improvement was 16 [10–21] points when the baseline QRS duration was <90 ms; 12 [4–20] when it was 90–110 ms; 5 [0–15] when it was 110 ± 130 ms; and 0 [0–6] points when it was >130 ms. Conclusions In patients with LV systolic dysfunction, intrinsic QRS duration is inversely related to the probability and the degree of echocardiographic response after frequent PVC ablation. Patients with a QRS duration >130 ms at baseline have the poorer response after ablation.

scholarly journals Difference in prevalence of exertional oscillatory ventilation between healthy subjects and patients with cardiovascular disease

2020 ◽  
Vol 90 (1) ◽  
Author(s):  
Ugo Corrà ◽  
Massimo Piepoli ◽  
Andrea Giordano
Keyword(s):  
Cardiovascular Disease ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Healthy Subjects ◽  
Normal Subjects ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Severe Impairment

Exercise oscillatory ventilation (EOV) is an ominous sign in heart failure due to reduced left ventricular ejection fraction (HFrEF) whatever it is represented. But EOV is detected also in normal healthy individuals and in other cardiovascular disease (CVD) patients, however, its prevalence in these is not completed clear. The aim was to describe the occurrence of EOV in healthy subjects and the overall population all CVD patients who performing symptom limited cardiopulmonary exercise testing (CPET). Healthy subjects were divided in athletes and normal subjects, while, CVD patients were subdivided into: i) t hose with preserved left ventricular ejection fraction (LVEF); ii) those with mild to moderate impairment of LVEF (41-49%); iii) those with severe impairment of LVEF (≤40%); iv) HFrEF or with preserved LVEF (HFpEF); and iv) patients after heart transplantation (HXT). EOV was observed only in CVD patients and in those with depressed LVEF; the prevalence of EOV was observed 1.9% (3/55) those with mild to moderate impairment of LVEF (41-49%), 3.4% (56/1613) those with severe impairment of LVEF (≤40%), and 7.3% (214/2903) in HFrEF); no EOV was observed in CVD with preserved LVEF. Kremser’s EOV was observed in patients, and, particularly, in those with systolic function impairment. Moreover, as EOV impacts prognosis in HFrEF, its occurrence can modify prognostic-decision models. Even though, EOV prevalence was derived from largest single center population, more studies are needed to tackle the EOV prevalence in different CVD conditions and in normal subjects.

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