Left ventricular function after noninvasive cardiac ablation using proton beam therapy in a porcine model
| Autor: | Jon J. Kruse, Douglas L. Packer, Robert L. Foote, Kay D. Parker, Atsushi Suzuki, Kristi H. Monahan, Hiroki Konishi, Michael G. Herman, Maryam E. Rettmann, Laura K. Newman, Stephan Hohmann, Kenneth W. Merrell, Amanda J. Deisher |
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| Rok vydání: | 2019 |
| Předmět: |
Cardiac function curve
Swine medicine.medical_treatment 030204 cardiovascular system & hematology Ventricular tachycardia Ventricular Function Left 03 medical and health sciences 0302 clinical medicine Cardiac magnetic resonance imaging Physiology (medical) Proton Therapy Animals Medicine 030212 general & internal medicine Ejection fraction Ventricular function medicine.diagnostic_test business.industry Dose-Response Relationship Radiation Radiotherapy Dosage Stroke Volume Cardiac Ablation Ablation medicine.disease Magnetic Resonance Imaging Radiation therapy Disease Models Animal Tachycardia Ventricular Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business Nuclear medicine |
| Zdroj: | Heart Rhythm. 16:1710-1719 |
| ISSN: | 1547-5271 |
| DOI: | 10.1016/j.hrthm.2019.04.030 |
| Popis: | Background Noninvasive cardiac ablation of ventricular tachycardia (VT) using radiotherapy has recently gained interest among electrophysiologists. The effects of left ventricular (LV) ablative radiation treatment on global LV function and volumes are unknown. Objective The purpose of this study was to investigate the effects of noninvasive ablation on LV function over time. Methods Twenty domestic swine underwent proton beam treatment of LV sites in a dose-finding design and were followed for up to 40 weeks by cardiac magnetic resonance imaging at 4-week intervals. Doses investigated were either 40 Gy at 1 site (n = 8) or 30 Gy at 2 sites (n = 4) in the low-dose group and 40 Gy at 3 sites (n = 8) in the high-dose group. Results LV mean dose (13.2 ± 1.8 Gy vs 4.6 ± 1.8 Gy) and the volume receiving at least 20 Gy (V20Gy) (24.7% ± 4.8% vs 6.4% ± 3.0%) differed significantly between groups. Dose-dependent effects on left ventricular ejection fraction (LVEF) and LV end-diastolic volume became manifest about 3 months after treatment. LVEF decline was correlated to mean dose (correlation coefficient ρ = –0.69; P = .008) and V20Gy (ρ = –0.66; P = .01), as was LV dilation (ρ = 0.72; P = .005; and ρ = 0.75, P = .003 respectively). Conclusion Possible adverse effects on LV function, seen about 3 months after treatment, are dose dependent. Therefore, precise target definition and focused energy delivery are paramount in catheter-free ablation. |
| Databáze: | OpenAIRE |
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