Retrospective

Cheuk Man Yu

Rm. 12A28, 12/F, Main Building, PWH

2632 1752

cmyu@cuhk.edu.hk / poonsps@yahoo.com.hk

Nil

Cheuk Man Yu

Rm.12A28, 12/F, main building, PWH

2632 1752

cmyu@cuhk.edu.hk / poonsps@yahoo.com.hk

Nil

Yes

2007-03-13

Procedure

Echocardiography assesses LV asynchrony in both systole and diastole of Acute Heart Failure Decompensation in Patients.

4 years

The study is a prospective, case-control design. It will employ advanced and sensitive echocardiographic technologies (ultrasound of the heart) to examine LV asynchrony in both systole (contraction) and diastole (relaxation), which include the tissue Doppler imaging (TDI) and real-time 3-dimensional echocardiography (3DE). In the cross-sectional study, 75 patients hospitalized for acute HF decompensation will be compared with another 75 patients with chronic stable HF to examine whether there are difference in the prevalence and severity of cardiac systolic and diastolic asynchrony. This will be performed by using a number of validated parameters of asynchrony based on TDI and 3DE, and 75 normal controls will be selected to provide the reference normal cutoff values. Then, patients will enter into the prospective study and will be followed up at 1, 3 and 6 months, and the changes of systolic and diastolic asynchrony will be examined by echocardiography and compared between the 2 HF groups. Lastly, these patients will undergo exercise stress echocardiography at or before 1-month follow up to test the hypothesis whether dynamic LV asynchrony is a common condition in the group of HF patients with recent acute HF decompensation, and whether it will contribute to exercise-induced mitral regurgitation.

1). Two groups of patients will be enrolled: (1) Patients who are admitted to acute medical ward for a diagnosis of acute HF (both first time presentation of HF or acute deterioration of chronic HF), (2) Patients with chronic stable HF who had no evidence of decompensation over the past 6 months; and,
2). evidence of left ventricular (LV) systolic dysfunction with ejection fraction <50%, and,
3). normal QRS duration of <120ms

1). HF with ejection fraction >50%
2). HF with wide QRS complex of >120ms
3). Patients with fluid overload due to other conditions, such as renal failure or non-cardiogenic pulmonary oedema
4). Patients with HF due to cardiac arrhythmia, thyrotoxicosis and other causes of high output HF
5). Patients with atrial fibrillation that will preclude accurate analysis of systolic asynchrony, in particular 3DE
6). Patients with poor image quality that preclude echocardiographic analysis
7). Patients with disease with expected life expectancy 6 months, such as malignancies
8). Patients who refuse to participate the study

Patient > 18 years of age

Patient > 18 years of age

Both Male and Female

Non-randomized

Active

Open label

Parallel

No

Yes

Nil