Cardiac resynchronization therapy improves minute ventilation/carbon dioxide production slope and skeletal muscle capillary density without reversal of skeletal muscle pathology or inflammation
| Autor: | Kate Myreng, Sigurd Lindal, Dennis W.T. Nilsen, Pål Aukrust, Kenneth Dickstein, Arne Yndestad, Christer Ogne, Jan Terje Kvaløy, Alf Inge Larsen, Peter Scott Munk |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Pathology medicine.medical_specialty medicine.medical_treatment Cardiac resynchronization therapy Diastole Cardiac Resynchronization Therapy QRS complex Oxygen Consumption Physiology (medical) Internal medicine medicine Humans Muscle Skeletal Aged Heart Failure Ejection fraction Myositis business.industry Skeletal muscle Carbon Dioxide medicine.disease Capillaries Treatment Outcome medicine.anatomical_structure Heart failure Cardiology Female Pulmonary Ventilation Cardiology and Cardiovascular Medicine business Respiratory minute volume Blood sampling |
| Zdroj: | Europace. 15:857-864 |
| ISSN: | 1532-2092 1099-5129 |
| DOI: | 10.1093/europace/eus428 |
| Popis: | Aims We evaluated the effects of cardiac resynchronization therapy (CRT) on skeletal muscle pathology and inflammation in patients with heart failure. Methods and results Stable patients ( n = 21, 14 males, mean age 70 ± 7 years) with symptomatic heart failure (mean left ventricular ejection fraction 24 ± 6%) and an indication for CRT were included. Ergospirometry, skeletal muscle open biopsy, and blood sampling were performed prior to implantation and after 6 months of CRT. After CRT there was a reduction in both left ventricular end-diastolic diameter (LVEDD; 6.8 ± 0.8 vs. 6.3 ± 0.7 cm, P < 0.001) and native QRS duration (D) minus biventricular paced QRSD (172.9 ± 23 vs. 136.3 ± 23 ms, P ≤ 0.001). These changes were associated with an increase in peak slope oxygen uptake (consumption) (VO2) (13.3 ± 2.2 vs. 14.5 ± 2.6 mL/kg/min, P = 0.07) and an improvement in the minute ventilation/carbon dioxide production slope (VE/VCO2) slope (41.6 ± 7.4 vs. 39.1 ± 5.6, P = 0.012). There were no statistically significant changes in levels of pro-inflammatory cytokines, in mediators of mitochondrial biosynthesis or skeletal muscle pathology, except for an increase in skeletal muscle capillary density (4.5 ± 2.4 vs. 7.7 ± 3.3%, P = 0.002). Both the reduction of QRS duration and the increase in peak VO2 correlated significantly with the change in mitochondrial density ( r = 0.57, P = 0.008 and r = 0.54, P = 0.027, respectively). Conclusion Cardiac resynchronization therapy, with improved functional status and reduced LVEDD resulted in increased peak VO2, improvement in VE/VCO2 slope and capillary density in skeletal muscle, with no reduction in systemic pro-inflammatory cytokines, increase in intramuscular levels of mediators of mitochondrial biosynthesis or improvement in skeletal muscle ultrastructure per se . ClinicalTrials.gov Identifier: [NCT01019915][1]. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT01019915&atom=%2Feuropace%2Fearly%2F2013%2F01%2F14%2Feuropace.eus428.atom |
| Databáze: | OpenAIRE |
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