Abstract 1854: Ventricular Dyssynchrony in Left Ventricular Hypertrophy with Normal Systolic Function
Background. Normal systolic function is present > 30% of patients with heart failure. The mechanism of heart failure in normal systolic function has been the subject of debate. The role of LV dyssynchrony in development of heart failure and normal systolic function in unclear.
Methods. Patients with echoes were eligible for study if LV EF ≥ 50%, hypertension and wall thickness ≥ 11mm, no evidence of valvular or ischemic disease, and normal QRS duration. Echo included 2D and Doppler echo with tissue Doppler imaging (TDI). Dyssynchrony was measured using time from QRS to peak systolic velocity on TDI (T-P) in 3 apical views. A group of normal studies was used to establish normal values for maximum differences in T-P (T-Pmax). Dyssynchrony was considered present if T-Pmax > 2SD of normal values.
Results. Study included 47 patients (22 women, 25 men), mean age 59.4 years (range 39–96). LV dyssynchrony was common, 22/47 (46.8%), and not related to age or calculated LV filling pressure. However, a significant relationship occurred between T-Pmax and LV mass (r=0.46,p=0.0015), as well as between T-Pmax and left atrial volume (r=0.41,p=0.005) (Figures 1⇓ and 2⇓).
Conclusion. Left ventricular dyssynchrony appears to be common among patients with LV hypertrophy. Important associations between LV dyssynchrony and the magnitude of left ventricular hypertrophy, as well as the degree of left atrial enlargement exist. These findings potentially provide explanation for the development of heart failure with normal systolic function.