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

Bashir Ahmad, M. Mijinyawa, M. Sani
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引用次数: 1

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.
尼日利亚卡诺州Aminu Kano教学医院心力衰竭患者的机电不同步与再入院和死亡的短期结局
背景:心脏非同步运动是指不同腔室和/或心脏不同节段收缩时间的差异。左心室(LV)非同步化常见于心力衰竭(HF)患者,如果不及时治疗,它是一个预后不良的标志。尼日利亚心衰患者的心脏非同步化运动的影响尚不清楚。我们从再入院和6个月心衰患者死亡率的角度出发,评估了机电不同步在短期预后中的作用。方法:对我院成年心衰患者进行前瞻性观察研究。分别用心电图和超声心动图测量电和机械不同步运动。收集6个月内再入院和死亡的结果数据。数据分析使用社会科学统计软件包(SPSS)第16版软件。结果:本研究共招募了100名参与者。11%的患者存在电不同步(心电图上QRS复波持续时间> 120ms),其中8例(73%)QRS宽度在120 ~ 150ms之间,3例QRS宽度> 150ms。室间非同步化(左室射血前间隔-右室射血前间隔≥40 ms)的发生率为79%,而室内非同步化(室间隔至后壁运动延迟>130 ms)的发生率为75%。19%的研究参与者因心衰症状恶化而再次入院,而高达37%的人在6个月的随访期内死亡。电不同步是短期再入院和死亡的重要预测因素。所有形式的不同步与死亡之间也有统计学差异(P < 0.005)。结论:机电不同步的存在与再入院和死亡的短期预后不良有关。在我们的环境中,我们需要更多的研究来完全定义心衰患者的非同步化负担。
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