Natural history of abnormal conduction and its relation to prognosis in patients with dilated cardiomyopathy
| Autor: | Han B. Xiao, Craig Roy, Derek G. Gibson, Shinichi Fujimoto |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Adult
Cardiomyopathy Dilated Male Bundle of His Pacemaker Artificial medicine.medical_specialty Heart block Cardiomyopathy QT interval Ventricular Function Left Electrocardiography QRS complex Internal medicine Humans Medicine Sinus rhythm Prospective Studies cardiovascular diseases PR interval Aged Retrospective Studies Heart Failure medicine.diagnostic_test business.industry Hemodynamics Reproducibility of Results Signal Processing Computer-Assisted Dilated cardiomyopathy Middle Aged medicine.disease Heart Block Echocardiography Atrioventricular Node cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | International Journal of Cardiology. 53:163-170 |
| ISSN: | 0167-5273 |
| Popis: | To investigate the natural history of disturbances in ventricular activation, atrioventricular conduction, and ventricular cavity size, we retrospectively studied 58 patients from a total of 296 patients with dilated cardiomyopathy seen within 4 years. A total of 309 computerised electrocardiograms (ECGs) and 135 M-mode echocardiograms were analysed. In the majority of the patients, PR interval, QRS duration and QT interval prolonged progressively, though heart rate changed little. Their increase was much more striking in patients who died (n = 10) or had a pacemaker inserted (n = 9), compared to that in the clinically stable patients, though at entry all these values, as well as age and left ventricular cavity size, were similar. There were no significant differences between patients who died and those with a pacemaker inserted, except for QRS axis, which had shifted rightwards in 8 out of 10 who died, but only in 3 of 9 who subsequently had a pacemaker inserted and 14 of the 29 stable patients. A QRS duration over 160 ms was found in 8 out of the 10 patients who died, 6 of 9 who had a pacemaker and only in 5 out of the 39 stable patients (P < 0.001). The sum of PR interval and QRS duration over 375 ms was not found in any stable patient but was present in 6 of the 7 patients who were in sinus rhythm and died (P < 0.001). Left ventricular cavity size also increased with time, but did not correlate significantly with ECG progression, nor did it identify patients who subsequently died. Thus, a combination of increasing PR interval and QRS duration, particularly along with rightwards shift of QRS axis, appears to be a marker of high risk in patients with dilated cardiomyopathy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect