Prognostic value of integrative analysis of electrical and mechanical dyssynchrony in patients with acute heart failure
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Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China College of Computing, Michigan Technological University, Houghton, MI School of Computer and Communication Engineering, Zhengzhou University of Light Industry, Zhengzhou, China
Received May 15, 2020; accepted Oct 17, 2020 doi:10.1007/s12350-020-02429-1
Background. Left ventricular mechanical dyssynchrony has been shown to provide significant clinical values for chronic heart failure (HF) and cardiac resynchronization therapy (CRT). The purpose of this study was to evaluate whether electrical dyssynchrony combined with mechanical dyssynchrony has an incremental benefit over electrical dyssynchrony or mechanical dyssynchrony alone to predict clinical events in patients with acute heart failure (AHF). Methods. Ninety-six AHF patients who received standard 12-lead ECG, gated singlephoton emission computed tomography (SPECT) myocardial perfusion imaging (MPI), and echocardiography were enrolled. Thirty-two normal subjects were collected as the control group to get the normal database of mechanical dyssynchrony. The end point is the composite of all-cause death and heart transplantation. Electrical dyssynchrony was defined as QRS duration > 120 ms. Mechanical dyssynchrony was defined as > mean 1 2 3 SD phase standard deviation (PSD) or phase bandwidth (PBW) based on our normal database. Results. During the follow-up of 28 ± 10 months, complete data were obtained in 92 patients. 26 (28.3%) Patients who reached the end point were classified into the event group. There were no significant differences in PSD or PBW between the event and non-event groups. However, PBW > 77.76° was independently associated with the end point in the univariate and multivariate analysis (hazard ratio 2.92, 95% confidence interval 1.00-8.47, P = .049; hazard ratio 3.89, 95% confidence interval 1.01-14.97, P = .048). The Kaplan-Meier curve with a logrank test showed that the end point rate was significantly higher in the patients with PBW > 77.76° (log-rank P = .039). Moreover, the ROC curve analysis showed that the area under the curve (AUC) for predicting end point events by the integrative analysis of QRS > 120 ms and
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12350-020-02429-1) contains supplementary material, which is available to authorized users. The authors have also provided an audio summary of the article, which is available to download as ESM, or to listen to via the JNC/ASNC Podcast. The authors of this article have provided a PowerPoint file, available for download at SpringerLink, which summarises the contents of the paper and is free for re-use at meetings and presentations. Search for the article DOI on SpringerLink.com.
Reprint requests: Yanli Zhou, MD, PhD, Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Guangzhou Road 300, Nanjing210029, China; [email protected] 1071-3581/$34.00 Copyright Ó 2020 American Society of Nuclear Cardiology.
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