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Restoration of ventricular septal hypoperfusion by cardiac resynchronization therapy in patients with permanent right ventricular pacing.
Ogano, Michio; Iwasaki, Yu-Ki; Tanabe, Jun; Takagi, Hisato; Umemoto, Takuya; Hayashi, Meiso; Miyauchi, Yasushi; Shimizu, Wataru.
Afiliación
  • Ogano M; Department of Cardiovascular Medicine, Shizuoka Medical Center, 762-1 Nagasawa, Shimizu, Sunto Shizuoka 4110906, Japan. Electronic address: m-ogano@nms.ac.jp.
  • Iwasaki YK; Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo, Tokyo 1138603, Japan.
  • Tanabe J; Department of Cardiovascular Medicine, Shizuoka Medical Center, 762-1 Nagasawa, Shimizu, Sunto Shizuoka 4110906, Japan.
  • Takagi H; Department of Cardiovascular Surgery, Shizuoka Medical Center, 762-1 Nagasawa, Shimizu, Sunto Shizuoka 4110906, Japan.
  • Umemoto T; Department of Cardiovascular Surgery, Shizuoka Medical Center, 762-1 Nagasawa, Shimizu, Sunto Shizuoka 4110906, Japan.
  • Hayashi M; Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo, Tokyo 1138603, Japan.
  • Miyauchi Y; Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo, Tokyo 1138603, Japan.
  • Shimizu W; Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo, Tokyo 1138603, Japan.
Int J Cardiol ; 224: 353-359, 2016 Dec 01.
Article en En | MEDLINE | ID: mdl-27673691
BACKGROUND: Pacing from the right ventricular apex (RVA) is associated with cardiac dysfunction and shows electrophysiological features similar to left bundle branch block in which left ventricular (LV) mechanical dyssynchrony impairs septal coronary artery perfusion. METHODS: A total of 62 non-ischemic patients with an implanted pacemaker at the RVA with a pacing rate of >95% were studied. LV septal coronary perfusion as indicated by the LV septal perfusion index was measured by electrocardiography (ECG)-gated single-photon emission computed tomography for all patients at baseline and for patients who were upgraded to CRT at 6months after CRT. Relationships among LV septal perfusion index, QRS duration, and LV ejection fraction were analyzed. RESULTS: Among the patients with permanent RVA pacing, 28 of 62 (45%) had impaired septal perfusion (i.e., septal perfusion index <0.9). The LV septal perfusion index was significantly correlated with both QRS duration (r=-0.763, p<0.001) and LV ejection fraction (r=0.462, p=0.001). Eleven patients were upgraded to CRT. CRT significantly improved the LV septal perfusion index from 0.63 (SD=0.13) to 0.89 (SD=0.19) (p<0.001)and cardiac function: LV end-systolic volume from 102.3mL (SD=70.0) to 179.7mL (SD=118.4) (p=0.002) and LV ejection fraction from 22.5 (SD=8.9%) to 38.4% (SD=13.9%) (p=0.001). CONCLUSIONS: Nearly half of the non-ischemic patients with permanent RVA pacing presenting with prolonged QRS duration and LV dysfunction developed LV septal hypoperfusion. Both septal perfusion and LV function improved in patients who were upgraded to CRT.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Disfunción Ventricular Izquierda / Vasos Coronarios / Tabique Interventricular / Terapia de Resincronización Cardíaca / Insuficiencia Cardíaca / Ventrículos Cardíacos Tipo de estudio: Diagnostic_studies Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Int J Cardiol Año: 2016 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Disfunción Ventricular Izquierda / Vasos Coronarios / Tabique Interventricular / Terapia de Resincronización Cardíaca / Insuficiencia Cardíaca / Ventrículos Cardíacos Tipo de estudio: Diagnostic_studies Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Int J Cardiol Año: 2016 Tipo del documento: Article Pais de publicación: Países Bajos