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KMID : 0338420100250030246
The Korean Journal of Internal Medicine
2010 Volume.25 No. 3 p.246 ~ p.252
Left Ventricular Dyssynchrony in Patients Showing Diastolic Dysfunction without Overt Symptoms of Heart Failure
Kim Jae-Hoon

Jang Hee-Sang
Bae Byung-Seok
Shin Seung-Min
Kim Ki-Ju
Park Jung-Gil
Kang Hyun-Jae
Lee Bong-Ryeol
Jung Byung-Chun
Abstract
Background/Aims: Few studies have assessed left ventricular (LV) dyssynchrony in cases of diastolic dysfunction that do not include overt symptoms of heart failure. We hypothesized that systolic or diastolic dyssynchrony involves unique features with respect to the degree of diastolic impairment in isolated diastolic dysfunction.

Methods: We examined 105 subjects with no history of overt symptoms of heart failure and a left ventricular ejection fraction > 50% for mechanical dyssynchrony using tissue Doppler imaging.

Results: In terms of longitudinal dyssynchrony, four cases showed (6.3%) LV intraventricular systolic dyssynchrony (SDSLV), whereas none had LV intraventricular diastolic dyssynchrony (DDSLV) or co-existing systolic dyssynchrony. Radial dyssynchrony (RD) was found in six cases (9.4%). After adjusting for age, SDSLV and DDSLV were found to be significantly related to increases in the E/E¡¯ ratio (r = 0.405 and p < 0.001 vs. r = 0.216 and p = 0.045, respectively). RD at the base and apex was also significantly related to increases in E/E¡¯ (r = 0.298 and p = 0.002 vs. r = 0.196 and p = 0.045, respectively).

Conclusions: Systolic and diastolic dyssynchrony in subjects with isolated diastolic dysfunction but without overt symptoms of heart failure was not as common as in patients with diastolic heart failure; however, the systolic and diastolic intraventricular time delay increased with increases in the E/E¡¯ ratio, an indicator of diastolic dysfunction.
KEYWORD
Diastolic dysfunction, Dyssynchrony, E/E¡¯ ratio, Speckle tracking image
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