Correlation Study on Left Ventricular Mechanical and Electrical Dyssynchrony in Patients with Chronic Heart Failure

Abstract Objective This study aimed to investigate the correlation between left ventricular (LV) mechanical and electrical dyssynchrony in patients with chronic heart failure (CHF). Methods A total of 412 patients with CHF were prospectively enrolled and stratified into a left ventricular synchrony group (LVs, n = 239) and a left ventricular dyssynchrony group (LVas, n = 173), based on the standard deviation of time to peak systolic velocity across 18 LV segments (SD18STE > 33 ms). Lasso regression was applied for variable selection, followed by multivariate logistic regression to identify independent factors influencing LV synchrony. Statistical methods were employed to evaluate the contribution of the 18 LV segments to heart failure pathology. Results Patients with CHF exhibited ventricular remodeling characterized by cardiac enlargement, reduced LV ejection fraction (LVEF), and impaired ventricular electrical conduction, as evidenced by prolonged QRS duration (≥ 120 ms). Compared with the LVs group, the LVas group showed significantly higher QRS duration (132.30 vs. 116.00 ms), NT-proBNP levels (2520 vs. 1820 ng/ml), LV end-diastolic volume (EDV: 211.05 vs. 142.00 ml), LV end-systolic volume (ESV: 170.70 vs. 96.50 ml), and prevalence of left bundle branch block (LBBB: 26.1% vs. 3.35%), along with significantly lower LVEF (20.70% vs. 34.20%) (all P < 0.05). Multivariate analysis identified QRS duration ≥ 120 ms (odds ratio [OR] = 1.65), ESV ≥ 155.36 ml (OR = 3.79), and LVEF < 35% (OR = 2.39) as independent predictors of LV dyssynchrony. Lasso regression identified eight key variables—including QRS duration, LBBB, ESV, LVEF, and SD values of time-to-peak systolic velocity in the anterior septal apex, posterior wall apex, posterior wall base, and inferior wall mid-segment—which were all significantly correlated with LV dyssynchrony (P < 0.05). Conclusion QRS duration ≥ 120 ms, ESV ≥ 155.36 ml, and LVEF < 35% are independent risk factors for LV dyssynchrony. Furthermore, QRS duration, LBBB, ESV, LVEF, and segmental time-to-peak systolic velocity variability demonstrate significant associations with mechanical dyssynchrony (P < 0.05).