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Mechanical Dyssynchrony Assessed by Tissue Doppler Imaging Is a Powerful Predictor of Mortality in Congestive Heart Failure With Normal QRS Duration

Goo-Yeong Cho, MD^_*,_*, Jae-Kwan Song, MD, FACC, Woo-Jung Park, MD^_*, Sung-Woo Han, MD^_*, Seung-Hyuk Choi, MD^_*, Young-Cheoul Doo, MD^_*, Dong-Jin Oh, MD^_* and Yung Lee, MD^_*

^_* Division of Cardiology, Hangang Sacred Heart Hospital, University of Hallym, Seoul, Korea
Division of Cardiology, Asan Medical Center, University of Ulsan, Seoul, Korea

View larger version (19K): [in a new window]   Figure 1 Percent of patients with clinical events and death by level of standard deviation of time to peak systolic point from R-wave on electrocardiogram (Ts-SD) (A) and the maximal temporal difference of Ts (Ts-diff). (B) *p < 0.01; p = 0.01; p = 0.05.

View larger version (10K): [in a new window]   Figure 2 Receiver-operating characteristic curve to determine the optimal cutoff value of the standard deviation of the time to peak systolic point from R-wave on electrocardiogram (Ts-SD). (A) and the maximal temporal difference of Ts (Ts-diff). (B) for predicting clinical events. AUC = area under the curve.

View larger version (20K): [in a new window]   Figure 3 Clinical event-free survival (top) and mortality-free survival (bottom) by Kaplan-Meier analysis. Patients with time interval from R-wave to peak systolic tissue velocity (Ts)-SD >37 ms were expressed in dashed lines and those with Ts-SD 37 ms in solid line. CI = confidence interval.

View larger version (19K): [in a new window]   Figure 4 Clinical event-free survival (top) and mortality-free survival (bottom) by Kaplan-Meier analysis. Patients with maximal temporal difference of time to peak systolic point from R-wave on electrocardiogram (Ts-diff) >91 ms were expressed in a dashed line and those with Ts-diff 91 ms in a solid line. CI = confidence interval.