Electromechanical dyssynchrony and short-term outcomes of readmission and death, among heart failure patients in Aminu Kano teaching hospital, Kano State, Nigeria

Abstract

Background: Cardiac dyssynchrony refers to a difference in the timing of contractions in different chambers and/or segments of the heart. Left ventricular (LV) dyssynchrony is frequently seen in patients with heart failure (HF) and is a poor prognostic marker if left untreated. The impact of cardiac dyssynchrony among HF patients in Nigeria is unknown. We set out to assess the role of electromechanical dyssynchrony in short-term outcomes in terms of readmission and 6-month mortality among HF patients in our hospital. Methods: We conducted a prospective observational study among adult HF patients in our hospital. Electrical and mechanical dyssynchrony were measured using electrocardiography and echocardiography, respectively. Data on the outcome of readmission and death within 6 months were collected. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 16 software. Results: A total of 100 participants were recruited for this study. Electrical dyssynchrony (Duration of QRS complex on ECG > 120ms) was found in 11%, 8 (73%) of them had QRS width between 120 and 150 ms, while in three, the QRS width was >150 ms. The prevalence of interventricular dyssynchrony (LV preejection interval – right ventricular preejection interval ≥40 ms) was found to be 79%, while that of intraventricular (septal to posterior wall motion delay >130 ms) was 75%. Nineteen percent of the study participants were readmitted with worsening HF symptoms, while up to 37% died within the 6 months follow-up period. Electrical dyssynchrony was a significant predictor of short-term readmission and death. There was also a statistically significant difference (P < 0.005) between all forms of dyssynchrony and death. Conclusion: The presence of electromechanical dyssynchrony is associated with a poor short-term outcome of readmission and death. More studies are needed in our country to fully define the burden of dyssynchrony among HF patients in our environment.