<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2304-0106</journal-id>
<journal-title><![CDATA[Anales de la Academia de Ciencias de Cuba]]></journal-title>
<abbrev-journal-title><![CDATA[Anales de la ACC]]></abbrev-journal-title>
<issn>2304-0106</issn>
<publisher>
<publisher-name><![CDATA[Academia de Ciencias de Cuba]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2304-01062023000200015</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Dispersión del QRS para determinar sincronía electromecánica en pacientes sometidos a estimulación cardiaca permanente]]></article-title>
<article-title xml:lang="en"><![CDATA[QRS dispersion to determine electromechanical synchrony in patients undergoing permanent cardiac stimulation]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Chávez González]]></surname>
<given-names><![CDATA[Elibet]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Carmona Puerta]]></surname>
<given-names><![CDATA[Raimundo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodríguez González]]></surname>
<given-names><![CDATA[Fernando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Nodarse Concepción]]></surname>
<given-names><![CDATA[Arian]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Ciencias Médicas Cardiocentro Ernesto Guevara Departamento de Electrofisiología invasiva]]></institution>
<addr-line><![CDATA[ Santa Clara]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de Ciencias Médicas Cardiocentro Ernesto Guevara Departamento de Ecocardiografía]]></institution>
<addr-line><![CDATA[ Santa Clara]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2023</year>
</pub-date>
<volume>13</volume>
<numero>2</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S2304-01062023000200015&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S2304-01062023000200015&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S2304-01062023000200015&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  Los estudios para determinar utilidad de la duración y dispersión del QRS en pacientes estimulados desde diferentes sitios cardiacos, son escasos. El objetivo fue demostrar la relación entre sincronía mecánica del corazón evaluada por ecocardiograma con la dispersión del QRS, en pacientes con marcapasos permanente, estimulados desde diferentes sitios cardiacos.  Métodos:  Se estudian 3 grupos. Primer grupo: 82 pacientes sometidos a estimulación en punta de ventrículo derecho; segundo grupo, 27 pacientes con disfunción sistólica secundaria a estimulación en punta de ventrículo derecho llevados a estimulación septal alta. Tercer grupo, 19 pacientes sometidos a terapia de resincronización cardiaca. Se estudian variables electrocardiográficas y ecocardiográficas para hallar sus relaciones en cuanto a sincronía electromecánica.  Resultados:  Primer grupo: La duración y dispersión del QRS mostraron incrementos significativos al correlacionarlas con decrementos de la fracción de eyección del ventrículo izquierdo en el seguimiento. Segundo grupo: La fracción de eyección se incrementó de 31 % ± 3,1 % a 45 % ± 12 % (p = 0,0041) con estimulación septal; esta mostró mejor grado de sincronía mecánica al evaluar por ecocardiografía, con correlación significativa e inversa entre dispersión del QRS y fracción de eyección. Tercer grupo: La correlación lineal entre fracción de eyección y dispersión del QRS a los 6 meses de seguimiento fue significativa (r = 0,34 y p = 0,02); las mujeres presentaron mayor dispersión del QRS (48,0 ms ± 24,0 ms vs. 37,14 ms ± 13,8 ms; p = 0,04) y mejor respuesta a la resincronización. Como conclusiones, la estimulación en punta de ventrículo derecho constituye un sitio que se relaciona con el deterioro contráctil del corazón; el incremento en la dispersión del QRS constituye una variable electrocardiográfica que puede predecir la disminución de la fracción de eyección. Los pacientes que recibieron estimulación septal mejoraron la sincronía electromecánica, esa mejoría pudiera ser determinada por decrementos de la dispersión del QRS. Por último, en los pacientes resincronizados, el decremento significativo de la dispersión del QRS puede predecir buena respuesta a la resincronización.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  Studies to determine usefulness of QRS duration and its dispersion in patients undergoing permanent cardiac pacing from different sites are scarce. A objective was to demonstrate the relationship between mechanical synchrony of the heart evaluated by echocardiography with QRS dispersion in patients with cardiac pacing stimulated from different cardiac sites.  Methods:  Three groups were studied. First group: 82 patients submitted to right ventricular apical pacing; second group, 27 patients with systolic dysfunction secondary to right ventricular apical pacing taken to high septal pacing. Third group: 19 patients undergoing cardiac resynchronization therapy. Electrocardiographic and echocardiographic variables were studied to determine if there is electromechanical synchrony relationship.  Results:  First group: QRS duration and its dispersion showed significant increases correlation when decreases left ventricular ejection fraction at follow-up. Second group: Ejection fraction increased from 31% ± 3,1% to 45% ± 12% (p = 0,0041) with septal pacing; this showed a better degree of mechanical synchrony when it was evaluated by echocardiography, with significant and inverse correlation between QRS dispersion and ejection fraction. Third group: Linear correlation between ejection fraction and QRS dispersion at six months of follow-up was significant (r = 0,34 and p = 0,02); women showed greater QRS dispersion (48,0 ± 24,0 vs. 37,14 ± 13,8) ms; p = 0,04 and better response to resynchronization. As some conclusions right ventricular apical pacing is related to cardiac contractile deterioration; increased QRS dispersion could be an electrocardiographic variable to predict a decreased left ventricular ejection fraction. Patients underwent septal stimulation improved electromechanical synchrony; decreased QRS dispersion could predict this improvement. Finally, decreased QRS dispersion may predict a good response to resynchronization therapy.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[estimulación cardiaca]]></kwd>
<kwd lng="es"><![CDATA[ecocardiografía]]></kwd>
<kwd lng="es"><![CDATA[función ventricular izquierda]]></kwd>
<kwd lng="es"><![CDATA[disincronía ventricular]]></kwd>
<kwd lng="en"><![CDATA[cardiac pacing]]></kwd>
<kwd lng="en"><![CDATA[echocardiography]]></kwd>
<kwd lng="en"><![CDATA[left ventricular function]]></kwd>
<kwd lng="en"><![CDATA[ventricular dyssynchrony]]></kwd>
</kwd-group>
</article-meta>
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