A Potentially Useful Marker to Determine Left Ventricular Dysfunction in Patients with Left Bundle Branch Block with Dilated Cardiomyopathy: Tpeak-Tend

Year 2017, Volume: 20 Issue: 2, 103 - 110, 01.08.2017

Abdullah İçli

Abstract

Introduction: It has
been shown in various epidemiological studies that left bundle branch block
(LBBB) is an independent risk factor of cardiac mortality. In this study, we
aimed to examine the relationship between left ventricular function in patients
with LBBB and the Tpeak-Tend (Tp-e) interval, which can be easily measured
using electrocardiography (ECG) when patients are admitted to the hospital.

Patients and Methods:
In
this study, 56 patients with LBBB were retrospectively selected according to
their echocardiographic findings by using the retrospective scanning method. In
line with this selection, patients were divided into two groups: patients with
ejection fraction (EF) < 50% (32.4 ± 3.7) and those with EF > 50% (58.2 ±
4.1). Tp-e/corrected Tp-e (cTp-e) intervals were measured using the surface
electrocardiogram technique.

Results: According
to our results, a negative correlation between Tp-e and EF in patients with
LBBB and dilated cardiomyopathy (DCMP) (r= -0.723, p= 0.0001). Tp-e had a
positive correlation with left ventricular end-diastolic diameter (LVEDd) (r=
0.394, p= 0.035) and with left ventricular end-systolic diameter (LVESd) (r=
0.478, p= 0.009). In the correlation analysis, we observed a negative
correlation between cTp-e and EF values (r= -0.649, p= 0.0001), and cTp-e had a
positive correlation with  LVEDd (r=
0.587, p= 0.001) as well as with LVESd (r= 0.558, p= 0.002).

Conclusion: Consequently, Tp-e/cTp-e
interval can be a useful parameter that can be used particularly in the
determination and follow-up of the patients whose left ventricular functions
have not yet been deteriorated. Furthermore, this value can be used to select
patients who can benefit from the treatment and to select the optimal timing of
resynchronization therapy.

Keywords

LBBB, dilated cardiomyopathy, Tpeak-Tend, ECG

LBBB Olan Dilate Kardiyomiyopati Hastalarında Sol Ventrikül Disfonksiyonunu Belirlemek İçin Potansiyel Olarak Faydalı Bir Marker: Tpeak-Tend

Abstract

Giriş: Sol dal bloğu (LBBB)’nun birçok epidemiyolojik çalışmada kardiyak
mortalitenin bağımsız bir risk faktörü olduğu gösterilmiştir. Son yapılan
çalışmalarda izole LBBB’ye spesifik progresif kardiyomiyopati (KMP)
gelişebileceği gösterilmiştir. Bu çalışmamızda LBBB olan hastalarda başvuru elektrokardiyografi
(EKG)‘sinde kolayca ölçülebilen Tpeak-Tend (Tp-e) intervalinin sol ventrikül
fonksiyonları ile ilişkisini araştırma amaçlanmıştır.

Hastalar ve
Yöntem: Bu çalışmaya retrospektif tarama ile 56 LBBB hastası
alınarak  ekokardiyografik değerlerine
göre; EF < %50 (60.2 ± 5.6 ) ve EF > %50 (58.1 ± 7) olarak 2 gruba
bölünerek incelendi. Tp-e/cTp-e intervalleri 
yüzey elektrokardiyogramlarından bilgisayar ortamında hassas ölçümler
elde etmek için bir dijital cetvel yardımıyla manuel olarak ölçüldü. Datalar
hasta dosyalarından elde edilen ekokardiyografik parametrelerle kıyaslandı.

Bulgular: LBBB ve dilate kardiyomiyopati (DKMP) hastalarında Tp-e ile EF arasında negatif
korelasyon (r= -0.723, p= 0.0001), sol ventrikül diyastol sonu çapı (SVDSÇ)
arasında ise  pozitif korelasyon (r=
0.394, p= 0.035) ve sol ventrikül sistol sonu çapı (SVSSÇ) ile pozitif
korelasyon (r= 0.478, p= 0.009) bulunmuştur. Korelasyon analizinde; cTp-e ile
EF arasında negatif korelasyon (r= -0.649, p= 0.0001), SVDSÇ arasında ise
pozitif korelasyon (r= 0.587, p= 0.001) ve SVSSÇ ile pozitif korelasyon (r=
0.558, p= 0.002)   bulunmuştur.

Sonuç: Sonuç olarak Tp-e/cTp-e
intervali özellikle sol ventrikül fonksiyonları henüz bozulmamış hastaların
belirlenmesinde, takibinde hatta tedaviden fayda görecek hasta seçiminde ve
resenkronizasyon tedavisinin optimal zamanlamasında potansiyel olarak faydalı
olabilecek bir parametre olabilir.

Keywords

LBBB, dilate kardiyomiyopati, Tpeak-Tend, EKG

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