Resumen

VILLARROEL-ABREGO, Hugo  y  GARILLO, Raúl. Índice de varianza versus duración del complejo QRS para el diagnóstico de dispersión mecánica del ventrículo izquierdo. Insuf. card. [online]. 2020, vol.15, n.1, pp.2-9. ISSN 1852-3862.

Introduction. The prediction of mechanical dyssynchrony has generally been based on the duration of the QRS complex, although other resources are available, such as the QRS variance index; these methods have not been compared with each other. Objective. Taking as a standard the left ventricular mechanical dispersion measured by speckle-tracking strain echocardiography, to assess the concordance between the average QRS duration of the standard electrocardiogram versus the spatial variance index in terms of sensitivity, specificity and predictive value of abnormal mechanical dispersion. Methods. Population of consecutive patients cited for strain echocardiography and without ventricular scar tissue, to measure mechanical dispersion, average QRS duration of the standard electrocardiogram and the variance index. Results. Fifty-four patients and 57 different scenarios were evaluated; the average age was 66.3±14.2 years, the QRS average duration on standard electrocardiogram was 119.7±31.5 ms. Average ID was 0.52±0.35. A spatial variation index >0.4 showed sensitivity and specificity of 82.6% and 64.7% respectively, for the diagnosis of abnormal mechanical dispersion (e"56 ms); positive predictive value: 61.3%, negative: 84.6%. The average duration of QRS e"130 ms achieved sensitivity and specificity of 52.6% and 71%, and the positive and negative predictive values were 54.5 and 68.6%, respectively. The average QRS duration are not interdependent with mechanical dyssynchrony (p=0.1458); mechanical dyssynchrony (>56 ms) and spatial variance electrocardiography are, nevertheless, clearly interdependent (p=0.0012). The methods are not comparable between them (kappa=0.376). Conclusion. The QRS variation electrocardiogram has better sensitivity and negative predictive value respect to the average QRS duration for the diagnosis of left ventricular mechanical dispersion prevalence, measured by echocardiography.

Palabras clave : Dyssynchrony; Left ventricular mechanical dispersion; QRS duration; QRS variance index.

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