Biventricular mechanical asynchrony predicts hemodynamic effect of uni- and biventricular pacing
| Autor: | Julio C. Spinelli, Andrew P. Kramer, Yinghong Yu, Angelo Auricchio, Walter Hoersch, Jiang Ding |
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| Rok vydání: | 2003 |
| Předmět: |
Male
Pacemaker Artificial medicine.medical_specialty Heart disease Physiology Heart Ventricles Bundle-Branch Block Hemodynamics Ventricule gauche Physiology (medical) Internal medicine Ventricular Pressure medicine Humans Heart Atria cardiovascular diseases Aged Heart Failure business.industry Middle Aged medicine.disease Myocardial Contraction Asynchrony (computer programming) Heart failure Anesthesia cardiovascular system Cardiology Female Intraventricular conduction delay Cardiology and Cardiovascular Medicine business |
| Zdroj: | American Journal of Physiology-Heart and Circulatory Physiology. 285:H2788-H2796 |
| ISSN: | 1522-1539 0363-6135 |
| Popis: | We tested whether biventricular resynchronization explains contractile function changes with univentricular and biventricular pacing in heart failure patients with varying magnitudes of baseline biventricular asynchrony. Thirty patients (New York Hospital Association class ≥ III, QRS duration ≥120 ms) were tested. Contractile function was measured by left ventricular maximum first derivative of pressure over time (dP/d tmax). Biventricular mechanical asynchrony was quantified by the normalized pressure-pressure (NPP) loop area formed by the cross-plot of right and left intraventricular pressure curves from each cardiac cycle. Any ventricular pacing increased dP/d tmax if it decreased baseline NPP loop area and almost always worsened dP/d tmax and asynchrony when baseline NPP loop area max and NPP loop area change depended on ventricular pacing site and timing relative to intrinsic activation. For similar NPP loop decreases, dP/d tmax increased 16% more with left and biventricular pacing compared with right ventricular pacing. In conclusion, right, left, or biventricular pacing can improve contractile function only in patients having sufficient baseline biventricular asynchrony. However, biventricular resynchronization is only one of the improvement mechanisms. |
| Databáze: | OpenAIRE |
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