ISSN 2149-2263 | E-ISSN 2149-2271 Home      
 
Volume : 24 Issue : 2
Current Issue Archive Popular Article Ahead of Print

 
Papillary muscle dyssynchrony as a cause of functional mitral regurgitation in non-ischemic dilated cardiomyopathy patients with narrow QRS complexes [Anatol J Cardiol]
Anatol J Cardiol. 2009; 9(3): 196-203

Papillary muscle dyssynchrony as a cause of functional mitral regurgitation in non-ischemic dilated cardiomyopathy patients with narrow QRS complexes

Kürşat Tigen1, Tansu Karaahmet1, Emre Gürel1, Cihan Çevik2, Mohammad Otahbachi3, Selçuk Pala4, Ali Cevat Tanalp5, Bülent Mutlu6, Yelda Başaran1
1Department of Cardiology, Kartal Koşuyolu Heart, Education and Research Hospital, İstanbul, Turkey
2Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
3Department of Cardiology Texas Tech University Health Sciences Center, Lubbock, TX, USA
4Department of Cardiology, Rize State Hospital, Rize
5Kartal Kosuyolu Heart and Research Hospital, Cardiology, İstanbul, Turkey
6Department of Cardiology, Faculty of Medicine, Marmara University, İstanbul, Turkey

Objective: Mitral regurgitation (MR) increases mortality in dilated cardiomyopathy (DCM). We investigated the prevalence of functional MR in non-ischemic DCM patients with narrow QRS intervals and its association with papillary muscle dyssynchrony. Methods: Ninety-three patients were enrolled consecutively in this cross-sectional study. Patients were evaluated for the presence of intraventricular (DYS Sep-Lat Sys) and papillary muscle (DYS Inter PAP Sys) systolic dyssynchrony using tissue Doppler echocardiographic imaging (TDI). Two-dimensional and Doppler echocardiography were used for quantification of MR. Statistical analyses were performed using unpaired t test, Mann-Whitney U test, correlation and logistic regression analyses. Results: Thirty-seven patients (39%) had significant DYS Sep-Lat Sys and 25 patients (26%) had DYS Inter PAP Sys. Patients with DYS Inter PAP Sys had lower basal septum systolic (p=0.007) and late diastolic velocities (p=0.049), greater MR volume (p=0.01), effective regurgitant orifice (ERO) (p=0.01), and E/A ratios (p=0.03) than the patients without DYS Inter PAP Sys. Fifty-five patients with narrow QRS intervals were also evaluated for DYS Inter PAP Sys. Patients with DYS Inter PAP Sys and narrow QRS had lower basal septum TDI peak systolic velocities (p=0.038), higher MR volume (p=0.03) and ERO (p=0.03). Logistic regression analysis revealed that NYHA Class III-IV (OR=6.4, 95% CI: 1.1-37.1, p=0.038) and DYS Inter PAP Sys (OR=9.5, 95% CI: 1.17-75.78, p=0.034) were the independent predictors of functional MR >20 ml. Conclusion: Papillary muscle systolic dyssynchrony is common and correlated with functional MR in non-ischemic DCM patients with sinus rhythm and narrow QRS. Papillary muscle systolic dyssynchrony may help predict patients who will benefit from cardiac resynchronization therapy.

Keywords: Dyssynchrony, cardiomyopathy, papillary muscle, mitral regurgitation, logistic regression analysis


Kürşat Tigen, Tansu Karaahmet, Emre Gürel, Cihan Çevik, Mohammad Otahbachi, Selçuk Pala, Ali Cevat Tanalp, Bülent Mutlu, Yelda Başaran. Papillary muscle dyssynchrony as a cause of functional mitral regurgitation in non-ischemic dilated cardiomyopathy patients with narrow QRS complexes. Anatol J Cardiol. 2009; 9(3): 196-203


TOOLS
Full Text PDF
Print
Download citation
RIS
EndNote
BibTex
Medlars
Procite
Reference Manager
Share with email
Share


Similar articles
PubMed
Google Scholar




 
 
KARE Publishing | Copyright © 2019 Turkish Society of Cardiology