The research of left and right ventricular contraction synchrony in patients with chronic heart failure

Objective:To observe contraction desynchronization of the left and right ventricle and alterations of electrocardiography and left ventricular geometric shape in patients with chronic congestive heart failure in sinus rhythm. To explore the incidence of interventricular desynchronization in patients with chronic congestive heart failur and the correlation among biventricular contractile desynchronization, left ventricular function, left ventricular geometric shape and mitral regurgitation.Methods:Twenty-two patients in sinus rhythm with chronic congestive heart failure who fulfill the Framingham heart failure diagnostic criteria (NYHA class II～III) and sixteen control subjects were studied by standard 12-lead electrocardiography(QRS duration, P-R duration were obtained), two dimensional echocardiography(Gibson's index, Cole's index, Area length index and mitral regurgitation were computed), and gated equilibrium blood pool scintigraphy (functional parameters of Left ventricular and right ventricular, Phase angles and full width at half maximum were computed).Results:Patients with chronic heart failure had significantly abnormal electrocardiography(QRS duration, P-R duration)(P 0.05), heart geometric shape(Cole's index, Area-length index) both at end-systole and end-diastole(P 0.05), left ventricular systolic function(P 0.01), and phase image(P 0.01). Seventy-seven percent patients with heart failure had interventricular contractile desynchrony who had lower left ventricular ejection fraction and more severe mitral regurgitation compared with patients without interventricular contractile desynchrony. A significant negative correlation was found between phase angles and LVEF(r= -0.55,P 0.05), and positive correlations were found between phase angles and mitral regurgitation(r= 0.568,P 0.05), and Cole's index、Area-length index of left ventricle at end-diastole(r= 0.532,P 0.05;r= 0.532,P 0.05).Conclusion:These findings show that interventricular contractile desynchronization may result from the changes of left ventricular geometric shape and the occurrence of mitral regurgitation. Interventricular contractile desynchronization may be one of causes of left ventricular function decneasing.