Conductance catheter-derived indexes of mechanical dyssynchrony showed marked differences between heart failure and control patients, correlating highly with tissue-Doppler velocity imaging.
Observational (n=18)
Can new indexes derived from conductance catheter signals accurately quantify left ventricular mechanical dyssynchrony in heart failure patients?
New indexes derived from conductance catheter signals can feasibly quantify left ventricular mechanical dyssynchrony and correlate well with established tissue-Doppler imaging techniques.
Mechanical dyssynchrony is an important codeterminant of cardiac dysfunction in heart failure. Treatment, either medical, surgical, or by pacing, may improve cardiac function partly by improving mechanical synchrony. Consequently, the quantification of ventricular mechanical (dys)synchrony may have important diagnostic and prognostic value and may help to determine optimal therapy. Therefore, we introduced new indexes to quantify temporal and spatial aspects of mechanical dyssynchrony derived from online segmental conductance catheter signals obtained during diagnostic cardiac catheterization. To test the feasibility and usefulness of our approach, we determined cardiac function and left ventricular mechanical dyssynchrony by the conductance catheter in heart failure patients with intraventricular conduction delay (n = 12) and in patients with coronary artery disease (n = 6) and relatively preserved left ventricular function. The heart failure patients showed depressed systolic and diastolic function. However, the most marked hemodynamic differences between the groups were found for mechanical dyssynchrony, indicating a high sensitivity and specificity of the new indexes. Comparison of conductance catheter-derived indexes with septal-to-lateral dyssynchrony derived by tissue-Doppler velocity imaging showed highly significant correlations. The proposed indexes provide additional, new, and quantitative information on temporal and spatial aspects of mechanical dyssynchrony. They may refine diagnosis of cardiac dysfunction and evaluation of interventions, and ultimately help to select optimal therapy.
Steendijk et al. (2004) conducted an observational in Heart failure with intraventricular conduction delay (n=18). Conductance catheter-derived indexes of mechanical dyssynchrony vs. Patients with coronary artery disease and relatively preserved left ventricular function was evaluated on Cardiac function and left ventricular mechanical dyssynchrony. Conductance catheter-derived indexes of mechanical dyssynchrony showed marked differences between heart failure and control patients, correlating highly with tissue-Doppler velocity imaging.