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Dynamic Ventricular Dyssynchrony

An Exercise-Echocardiography Study

Stephane Lafitte, MD, PhD^_*,b, Pierre Bordachar, MD^_*,b, Marianne Lafitte, MD^_*,b, Stephane Garrigue, MD, PhD^_*, Sylvain Reuter, MD^_*, Patricia Reant, MD^_*, Karim Serri, MD^_*, Valerie Lebouffos, MD^_*, Marianne Berrhouet, MD^_*, Pierre Jais, MD, PhD^_*, Michel Haissaguerre, MD^_*, Jacques Clementy, MD^_*, Raymond Roudaut, MD^_* and Anthony N. DeMaria, MD^,a,_*

^_* Cardiologic Hospital, Pessac and Bordeaux 2 University, Bordeaux, France
Division of Cardiology, University of California at San Diego, San Diego, California

View larger version (19K): [in a new window]   Figure 1 Three systolic phases analyzed for left ventricular dyssynchrony assessment. DLC = delayed longitudinal contraction; EKG = electrocardiogram; TO = time to onset of first shortening wave during ejection; TP = time to peak shortening wave during ejection.

View larger version (21K): [in a new window]   Figure 2 Percentage of heart failure patients with abnormal ventricular dyssynchrony at rest. %DLC = extent of myocardium showing delayed longitudinal contraction; Inter-V = interventricular dyssynchrony; SD-12 = standard deviation of TP of the 12 left ventricular segments; TO-6base = maximal difference in TO between any two of six basal left ventricular segments; TP-6base = maximal difference in TP between any two of six basal segments; TP-sep-lat = difference between TP of septobasal and laterobasal segments.

View larger version (22K): [in a new window]   Figure 3 Percentage of heart failure patients with abnormal ventricular dyssynchrony during exercise. Abbreviations as in Figure 2.

View larger version (49K): [in a new window]   Figure 4 Percentage of patients with at least a 20% increase, at least a 20% decrease, or a stable value of dyssynchrony during exercise. Abbreviations as in Figure 2.

View larger version (51K): [in a new window]   Figure 5 Example of one patient with a limited delay between septobasal and laterobasal segments peak of velocity at rest and major dyssynchrony during exercise. Abbreviation as in Figure 2.

View larger version (31K): [in a new window]   Figure 6 Percentage of patients with either exercise induction or normalization of ventricular dyssynchrony during exercise. Abbreviations as in Figure 2.