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Global and Regional Left Ventricular Contractile Impairment in Patients with Wolff-Parkinson-White Syndrome

BACKGROUND: To assess regional systolic function and global contractile function in patients with WPW Syndrome. METHOD: Eleven cases with manifest Wolff-Parkinson-White (WPW) syndrome in sinus rhythm were compared to 11 age matched controls. 2D strain analysis was performed and peak segmental radial...

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Autores principales: Afonso, Luis, Pradhan, Jyotiranjan, Veeranna, Vikas, Niraj, Ashutosh, Jacob, Sony
Formato: Texto
Lenguaje:English
Publicado: Indian Heart Rhythm Society 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2705315/
https://www.ncbi.nlm.nih.gov/pubmed/19652729
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author Afonso, Luis
Pradhan, Jyotiranjan
Veeranna, Vikas
Niraj, Ashutosh
Jacob, Sony
author_facet Afonso, Luis
Pradhan, Jyotiranjan
Veeranna, Vikas
Niraj, Ashutosh
Jacob, Sony
author_sort Afonso, Luis
collection PubMed
description BACKGROUND: To assess regional systolic function and global contractile function in patients with WPW Syndrome. METHOD: Eleven cases with manifest Wolff-Parkinson-White (WPW) syndrome in sinus rhythm were compared to 11 age matched controls. 2D strain analysis was performed and peak segmental radial strain (pRS) values obtained from basal ventricular parasternal short-axis images (70 ± 5 frames/sec) using a dedicated software package. Heterogeneity of radial strain pattern in six circumferential basal left ventricular segments was measured in terms of standard deviations of peak RS (SD(pRS)) or range (difference between maximum and minimum peak RS i.e. Range(pRS)). Spectral Doppler (continuous wave) measurements were acquired through the left ventricular outflow tract to determine Pre Ejection Period (PEP), Left Ventricular Ejection Time (LVET) and measures of left ventricular systolic performance. RESULTS: LV segmental radial strain was profoundly heterogeneous in WPW cases in contrast to fairly homogenous strain pattern in normal subjects. Wide SD(pRS) values 17.5 ± 8.9 vs 3.3 ± 1.4, p<0.001 and Range(pRS) 42.7 ± 20.8 vs.8.5 ± 3.6 , p<0.001 were observed among WPW and healthy subjects respectively. PEP (132.4 ± 14.7 vs 4.7 ± 0.5ms, p<0.001) and corrected PEP (76.1 ± 8.0 vs 2.7 ± 0.4ms, p<0.001) were significantly longer in WPW patients compared to controls. The PEP/LVET ratio was also significantly greater in WPW cohort (0.49 ± 0.04 vs. 0.28 ± 0.05, p <0.001) suggesting global systolic dysfunction. CONCLUSIONS: Patients with manifest preexcitation (predominantly those with right-sided pathways) have regional and global contractile dysfunction resulting from aberrant impulse propagation inherent to the preexcited state.
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spelling pubmed-27053152009-08-03 Global and Regional Left Ventricular Contractile Impairment in Patients with Wolff-Parkinson-White Syndrome Afonso, Luis Pradhan, Jyotiranjan Veeranna, Vikas Niraj, Ashutosh Jacob, Sony Indian Pacing Electrophysiol J Original Article BACKGROUND: To assess regional systolic function and global contractile function in patients with WPW Syndrome. METHOD: Eleven cases with manifest Wolff-Parkinson-White (WPW) syndrome in sinus rhythm were compared to 11 age matched controls. 2D strain analysis was performed and peak segmental radial strain (pRS) values obtained from basal ventricular parasternal short-axis images (70 ± 5 frames/sec) using a dedicated software package. Heterogeneity of radial strain pattern in six circumferential basal left ventricular segments was measured in terms of standard deviations of peak RS (SD(pRS)) or range (difference between maximum and minimum peak RS i.e. Range(pRS)). Spectral Doppler (continuous wave) measurements were acquired through the left ventricular outflow tract to determine Pre Ejection Period (PEP), Left Ventricular Ejection Time (LVET) and measures of left ventricular systolic performance. RESULTS: LV segmental radial strain was profoundly heterogeneous in WPW cases in contrast to fairly homogenous strain pattern in normal subjects. Wide SD(pRS) values 17.5 ± 8.9 vs 3.3 ± 1.4, p<0.001 and Range(pRS) 42.7 ± 20.8 vs.8.5 ± 3.6 , p<0.001 were observed among WPW and healthy subjects respectively. PEP (132.4 ± 14.7 vs 4.7 ± 0.5ms, p<0.001) and corrected PEP (76.1 ± 8.0 vs 2.7 ± 0.4ms, p<0.001) were significantly longer in WPW patients compared to controls. The PEP/LVET ratio was also significantly greater in WPW cohort (0.49 ± 0.04 vs. 0.28 ± 0.05, p <0.001) suggesting global systolic dysfunction. CONCLUSIONS: Patients with manifest preexcitation (predominantly those with right-sided pathways) have regional and global contractile dysfunction resulting from aberrant impulse propagation inherent to the preexcited state. Indian Heart Rhythm Society 2009-07-01 /pmc/articles/PMC2705315/ /pubmed/19652729 Text en Copyright: © 2009 Afonso et al. http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Afonso, Luis
Pradhan, Jyotiranjan
Veeranna, Vikas
Niraj, Ashutosh
Jacob, Sony
Global and Regional Left Ventricular Contractile Impairment in Patients with Wolff-Parkinson-White Syndrome
title Global and Regional Left Ventricular Contractile Impairment in Patients with Wolff-Parkinson-White Syndrome
title_full Global and Regional Left Ventricular Contractile Impairment in Patients with Wolff-Parkinson-White Syndrome
title_fullStr Global and Regional Left Ventricular Contractile Impairment in Patients with Wolff-Parkinson-White Syndrome
title_full_unstemmed Global and Regional Left Ventricular Contractile Impairment in Patients with Wolff-Parkinson-White Syndrome
title_short Global and Regional Left Ventricular Contractile Impairment in Patients with Wolff-Parkinson-White Syndrome
title_sort global and regional left ventricular contractile impairment in patients with wolff-parkinson-white syndrome
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2705315/
https://www.ncbi.nlm.nih.gov/pubmed/19652729
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