Mechanical dyssynchrony: How do we measure it, what it means, and what we can do about it.

Journal Article (Journal Article)

Left ventricular mechanical dyssynchrony (LVMD) is defined by a difference in the timing of mechanical contraction or relaxation between different segments of the left ventricle (LV). Mechanical dyssynchrony is distinct from electrical dyssynchrony as measured by QRS duration and has been of increasing interest due to its association with worse prognosis and potential role in patient selection for cardiac resynchronization therapy (CRT). Although echocardiography is the most used modality to assess LVMD, some limitations apply to this modality. Compared to echo-based modalities, nuclear imaging by gated single-photon emission computed tomography (GSPECT) myocardial perfusion imaging (MPI) has clear advantages in evaluating systolic and diastolic LVMD. GSPECT MPI can determine systolic and diastolic mechanical dyssynchrony by the variability in the timing in which different LV segments contract or relax, which has prognostic impact in patients with coronary artery disease and heart failure. As such, by targeting mechanical dyssynchrony instead of electrical dyssynchrony, GSPECT MPI can potentially improve patient selection for CRT. So far, few studies have investigated the role of diastolic dyssynchrony, but recent evidence seems to suggest high prevalence and more prognostic impact than previously recognized. In the present review, we provide an oversight of mechanical dyssynchrony.

Full Text

Duke Authors

Cited Authors

  • Fudim, M; Dalgaard, F; Fathallah, M; Iskandrian, AE; Borges-Neto, S

Published Date

  • May 29, 2019

Published In

PubMed ID

  • 31144228

Electronic International Standard Serial Number (EISSN)

  • 1532-6551

Digital Object Identifier (DOI)

  • 10.1007/s12350-019-01758-0

Language

  • eng

Conference Location

  • United States