Prediction of Acute Response to Cardiac Resynchronization Therapy by Means of the Misbalance in Regional Left Ventricular Myocardial Work
Autor: | LiNa Wu, Robin Nijveldt, Cornelis P. Allaart, Albert C. van Rossum, Gerben J. de Roest, Carel C. de Cock, Alwin Zweerink |
---|---|
Přispěvatelé: | Cardiology, ICaR - Heartfailure and pulmonary arterial hypertension, ICaR - Ischemia and repair |
Jazyk: | angličtina |
Rok vydání: | 2016 |
Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Bundle-Branch Block Cardiac resynchronization therapy Ventricular Septum 030204 cardiovascular system & hematology Ventricular Function Left 030218 nuclear medicine & medical imaging Cardiac Resynchronization Therapy 03 medical and health sciences QRS complex Electrocardiography Ventricular Dysfunction Left 0302 clinical medicine Internal medicine medicine Humans cardiovascular diseases Aged Retrospective Studies Heart Failure medicine.diagnostic_test Bundle branch block business.industry Left bundle branch block Work (physics) Magnetic resonance imaging Middle Aged medicine.disease Magnetic Resonance Imaging Heart failure cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business |
Zdroj: | Zweerink, A, De Roest, G J, Wu, L, Nijveldt, R, De Cock, C C, Van Rossum, A C & Allaart, C P 2016, ' Prediction of Acute Response to Cardiac Resynchronization Therapy by Means of the Misbalance in Regional Left Ventricular Myocardial Work ', Journal of Cardiac Failure, vol. 22, no. 2, pp. 133-142 . https://doi.org/10.1016/j.cardfail.2015.10.020 Journal of Cardiac Failure, 22(2), 133-142. Churchill Livingstone |
ISSN: | 1071-9164 |
DOI: | 10.1016/j.cardfail.2015.10.020 |
Popis: | Background Patients with left ventricular (LV) dyssynchrony have a marked misbalance in LV myocardial work distribution, with wasted work in the septum and increased work in the lateral wall. We hypothesized that a low septum-to-lateral wall (SL) myocardial work ratio at baseline predicts acute LV pump function improvement during cardiac resynchronization therapy (CRT). Methods and Results Twenty patients (age 65 ± 10 y, 15 men) underwent cardiac magnetic resonance (CMR) tagging for regional LV circumferential strain assessment and invasive pressure-volume loop assessment at baseline and during biventricular pacing. Segmental work at baseline was calculated from regional strain rate and LV pressure. Subsequently, the SL work ratio was calculated and related to acute pump function (stroke work [SW]) improvement during CRT. During biventricular pacing, SW increased by 33% ( P .001). SL work ratio at baseline was found to be significantly related to SW improvement by means of CRT ( R = −0.54; P = .015). Moreover, it proved to be the only marker that was significantly related to acute response to CRT, whereas QRS duration and other measures of dyssynchrony or dyscoordination were not. Conclusions The contribution of the septum to LV work varies widely in CRT candidates with left bundle branch block. The lower the septal contribution to myocardial work at baseline, the higher the acute pump function improvement that can be achieved during CRT. |
Databáze: | OpenAIRE |
Externí odkaz: |