Trial reportEuropean journal of heart failure2017
Prognostic importance of left ventricular mechanical dyssynchrony in heart failure with preserved ejection fraction.
Trial report in European journal of heart failure, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00094302 (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist), which is not on this map. Cited by 16 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT)
Who cites it
16 citing papers in PubMed, 39 citations in OpenAlex.
- Role of dyssynchrony in short-term left ventricular systolic function after iron repletion in patients with heart failure.Communications medicine · 2026Article
- Prognostic implications of left ventricular mechanical dispersion in comparison with QRS duration in heart failure with reduced ejection fraction.Quantitative imaging in medicine and surgery · 2025Article
- Blood volume contributes to the mechanical synchrony of the myocardium during moderate and high intensity exercise in women.European journal of applied physiology · 2024Article
- Ventricular dyssynchrony late after the Fontan operation is associated with decreased survival.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2023Article
- Mechanical dispersion combined with global longitudinal strain estimated by three dimensional speckle tracking in patients with ST elevation myocardial infarction.International journal of cardiology. Heart & vasculature · 2022Article
- Does types of atrial fibrillation matter in the impairment of global and regional left ventricular mechanics and intra-ventricular dyssynchrony?Frontiers in cardiovascular medicine · 2022Article
- Mechanical dyssynchrony: How do we measure it, what it means, and what we can do about it.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Article
- Heart failure with preserved ejection fraction based on aging and comorbidities.Journal of translational medicine · 2021Review
- The prognostic value of left atrial dyssynchrony measured by speckle tracking echocardiography in the general population.The international journal of cardiovascular imaging · 2021Article
- Layer-specific strain and dyssynchrony index alteration in new-onset systemic lupus erythematosus patients without cardiac symptoms.Quantitative imaging in medicine and surgery · 2021Article
- Left ventricular end-systolic contractile entropy can predict cardiac prognosis in patients with complete left bundle branch block.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Article
- Cardiac MRI Assessment of Mouse Myocardial Infarction and Regeneration.Methods in molecular biology (Clifton, N.J.) · 2021Article
- The prognostic value of diastolic and systolic mechanical left ventricular dyssynchrony among patients with coronary artery disease and heart failure.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2020Article
- Therapeutic approaches in heart failure with preserved ejection fraction: past, present, and future.Clinical research in cardiology : official journal of the German Cardiac Society · 2020Review
- Prognostic importance of mechanical dyssynchrony in predicting heart failure development after ST-segment elevation myocardial infarction.The international journal of cardiovascular imaging · 2019Article
- Left ventricular diastolic and systolic dyssynchrony and dysfunction in heart failure with preserved ejection fraction and a narrow QRS complex.International journal of medical sciences · 2018Article
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 2 countries.
Funding
Abstract
aimsLeft ventricular mechanical dyssynchrony has been described in heart failure with preserved ejection fraction (HFpEF), but its prognostic significance is not known. METHODS AND
resultsOf 3445 patients with HFpEF enrolled in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial, dyssynchrony analysis was performed on 424 patients (12%) by multiple speckle tracking echocardiography strain-based criteria. The primary dyssynchrony analysis was the standard deviation of the time to peak longitudinal strain (SD T2P LS). Cox proportional hazards models assessed the association of dyssynchrony with the composite outcome of cardiovascular death or heart failure hospitalization. Mean age was 70 ± 10 years, LVEF was 60 ± 8%, and QRS duration was 101 ± 27 ms. Worse dyssynchrony, reflected in SD T2P LS, was associated with wider QRS, prior myocardial infarction, larger LV volume and mass, and worse systolic (lower LVEF and global longitudinal strain) and diastolic (lower e' and higher E/e') function. During a median follow-up of 2.6 (interquartile range 1.5-3.8) years, 107 patients experienced the composite outcome. Worse dyssynchrony was associated with the composite outcome in unadjusted analysis [hazard ratio (HR) 1.04, 95% confidence interval (CI) 1.01-1.07; P = 0.021, per 10 ms increase], but not after adjusting for clinical characteristics, or after further adjustment for LVEF, AF, NYHA class, stroke, heart rate, creatinine, haematocrit, and QRS duration (HR 1.03, 95% CI 0.99-1.06; P = 0.16, per 10 ms increase).
conclusionWorse LV mechanical dyssynchrony, assessed by speckle tracking echocardiography, is not an independent predictor of adverse outcomes in HFpEF, suggesting that mechanical dyssynchrony is unlikely to be an important mechanism underlying this syndrome. These findings warrant validation in an independent study specifically designed to assess the prognostic utility of mechanical dyssynchrony in HFpEF.
trial registrationNCT00094302.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.