This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (45) Citing Articles via Google Scholar Google Scholar Articles by Yu, C.-M. Articles by Fung, J. W.-H. Search for Related Content PubMed Articles by Yu, C.-M. Articles by Fung, J. W.-H.

Benefits of Cardiac Resynchronization Therapy for Heart Failure Patients With Narrow QRS Complexes and Coexisting Systolic Asynchrony by Echocardiography

Cheuk-Man Yu, MD, FRCP^_*,_*, Yat-Sun Chan, FHKAM^_*, Qing Zhang, MM^_*, Gabriel W.K. Yip, MRCP^_*, Chi-Kin Chan, FHKAM, Leo C.C. Kum, MRCP^_*, LiWen Wu, BM^_*, Alex Pui-Wai Lee, MRCP^_*, Yat-Yin Lam, MRCP^_* and Jeffrey Wing-Hong Fung, FHKAM^_*

^_* Division of Cardiology, S. H. Ho Cardiovascular and Stroke Centre, Institute of Vascular Medicine, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China.

View larger version (12K): [in this window] [in a new window] [Download PPT slide]   Figure 1 Change in left ventricular (LV) end-systolic volume and severity of systolic asynchrony as measured by asynchrony index for heart failure patients with narrow (solid triangles) and wide (open triangles) QRS complexes. The regression lines for both groups nearly superimpose on each other with nearly identical slopes. Wide QRS: r = –0.71, p < 0.001; narrow QRS: r = –0.61, p < 0.001.

View larger version (11K): [in this window] [in a new window] [Download PPT slide]   Figure 2 The receiver-operating characteristics for identification of left ventricular reverse remodeling in heart failure patients with narrow (A) and wide (B) QRS complexes. The area under curve (AUC) is shown in each group.

View larger version (78K): [in this window] [in a new window] [Download PPT slide]   Figure 3 An example of a responder of cardiac resynchronization therapy (CRT) showing left ventricular (LV) reverse remodeling with reduction of LV end-systolic volume from 131 cc (A) to 78 cc (B) after CRT for 3 months. This patient had significant systolic asynchrony with asynchrony index (Ts-SD) of 41.0 ms at baseline. Tissue Doppler imaging showing great variations of time to peak systolic velocity (arrows) with delay in lateral wall at apical 4-chamber view (C), inferior wall at apical 2-chamber view (E), and posterior wall at apical long-axis (G) views. Such delay was abolished at the corresponding views after CRT for 3 months (D, F, and H). The asynchrony index was normalized to 21.4 ms.

View larger version (10K): [in this window] [in a new window] [Download PPT slide]   Figure 4 Comparison of changes in left ventricular end-systolic volume (LVESV) (A), left ventricular end-diastolic volume (LVEDV) (B), and left ventricular ejection fraction (EF) (C) in heart failure patients with narrow QRS complexes with and without significant systolic asynchrony according to asynchrony index.