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Abstract
To evaluate the relation between severity of left ventricular systolic dysfunction assessed by echocardiography and repolarisation abnormalities (duration of QTc interval , JTC interval and prolongation of QRS complex) on the surface ECG.
Patients and method:
This study included 30 patients with left ventricular systolic dysfunction diagnosed by echocardiography(EF% less than 50%) irrespective to the cause and the onset in the national heart institute. All patients subjected to full history taking, to full clinical examination and to echocardiography and ECG, all the patients are screened to serum electrolytes level (Na, K and Mg) with exclusion of the patients with electrolytes disturbance or taking drugs that affect the QT interval.
Results:
Among the 30 patients in this study there were 22 males (73.3%),18 patients(60%) were hypertensive, 50% of patients were diabetics , 10 of them were IDDM, 17 patients were smokers (56.7%),6 patients(20%) had LBBB, one patient had RBBB(3.3%), one patient had IVCD(3.3%), The QTc interval ranged between 370 - 530 msec with a mean value of 452.67±37.410.
The JTc interval ranged 330 - 490 msec with a mean value of 397±38.160. The QRS complex ranged between40-120 msec with a mean value of 54±24.598.
13 patients with NYHA grade I (43.4%),4 patients with NYHA grade II (13.3%),12 patients with NYHA grade III (40%) , 1 patient with NYHA grade IV (3.3%).
Serum K level ranged between 3.7 mEq/l to 5.1 mEq/l(mean 4.143±11.81). Serum Na level ranged between 130 mEq/l and 150 mEq/l (mean137.1±4.35). Serum Mg level ranged between 1.6 mg/dl to 2.3 mg/dl(mean 1.877±0.159).
The lowest EF detected was 15% and the highest was 47% (mean 36.4±9.41) .
The study included 24 patients(79.9%) had systolic dysfunction due to IHD , IHD was diagnosed by history analysis and confirmed by the presence of regional wall motion abnormalities on 2-D echocardiography basis. 16 patients showed IHD without associated valvular lesion (53.5%). 6 patients(20%) had IHD as well valvular lesion.