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Article: Area of left ventricular regional conduction delay and preserved myocardium predict responses to cardiac resynchronization therapy

TitleArea of left ventricular regional conduction delay and preserved myocardium predict responses to cardiac resynchronization therapy
Authors
Issue Date2005
PublisherWiley-Blackwell Publishing, Inc.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=1045-3873
Citation
Journal Of Cardiovascular Electrophysiology, 2005, v. 16 n. 7, p. 690-695 How to Cite?
AbstractCardiac Resynchronization Therapy. Background: A significant proportion of patients with dilated cardiomyopathy and left bundle branch block (LBBB) do not respond to cardiac resynchronization therapy (CRT). The purpose of this study was to investigate whether the electromechanical properties of the myocardium would predict acute hemodynamic improvement during left ventricular (LV) pacing. Methods and Results: We studied 10 patients with idiopathic dilated cardiomyopathy and LBBB (ejection fraction (EF): 27% ± 7%; QRS duration: 166 ± 16 msec) using three-dimensional electromechanical endocardial mapping technique to assess endocardial activation time (Endo-AT), unipolar voltage, and local linear shortening during sinus rhythm. LV stimulation was performed in VDD mode at five different sites and three atrioventricular delays within the coronary sinus. LV + dP/dtmax changes from baseline were measured during LV stimulation at each site (%ΔdP/dtmax). There was no significant relationship between maximum %AdP/dtmax during LV stimulation at the best coronary sinus site and LV EF, baseline LV + dP/dt max, total LV Endo-AT, baseline QRS duration nor changes in QRS duration during LV pacing. However, the maximum %AdP/dtmax was significantly positively correlated with percentage area of late Endo-AT (r = 0.97, P < 0.001) and preserved LV myocardium (r = 0.81, P = 0.005), respectively. Patients with >20% of LV area with late Endo-AT and >30% of preserved LV myocardium had five times better acute hemodynamic response with LV stimulation. Multivariate analysis snowed that only percentage area of late Endo-AT was independently correlated with %AdP/dtmax (P < 0.05). Conclusion: The presence of a larger amount of LV area with late Endo-AT and preserved LV myocardium measured by electromechanical mapping could identify patients who have better acute improvement in systolic performance during LV stimulation.
Persistent Identifierhttp://hdl.handle.net/10722/162863
ISSN
2015 Impact Factor: 3.097
2015 SCImago Journal Rankings: 1.863
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTse, HFen_US
dc.contributor.authorLee, KLFen_US
dc.contributor.authorWan, SHen_US
dc.contributor.authorYu, Yen_US
dc.contributor.authorHoersch, Wen_US
dc.contributor.authorPastore, Jen_US
dc.contributor.authorZhu, Qen_US
dc.contributor.authorKenknight, Ben_US
dc.contributor.authorSpinelli, Jen_US
dc.contributor.authorLau, CPen_US
dc.date.accessioned2012-09-05T05:24:32Z-
dc.date.available2012-09-05T05:24:32Z-
dc.date.issued2005en_US
dc.identifier.citationJournal Of Cardiovascular Electrophysiology, 2005, v. 16 n. 7, p. 690-695en_US
dc.identifier.issn1045-3873en_US
dc.identifier.urihttp://hdl.handle.net/10722/162863-
dc.description.abstractCardiac Resynchronization Therapy. Background: A significant proportion of patients with dilated cardiomyopathy and left bundle branch block (LBBB) do not respond to cardiac resynchronization therapy (CRT). The purpose of this study was to investigate whether the electromechanical properties of the myocardium would predict acute hemodynamic improvement during left ventricular (LV) pacing. Methods and Results: We studied 10 patients with idiopathic dilated cardiomyopathy and LBBB (ejection fraction (EF): 27% ± 7%; QRS duration: 166 ± 16 msec) using three-dimensional electromechanical endocardial mapping technique to assess endocardial activation time (Endo-AT), unipolar voltage, and local linear shortening during sinus rhythm. LV stimulation was performed in VDD mode at five different sites and three atrioventricular delays within the coronary sinus. LV + dP/dtmax changes from baseline were measured during LV stimulation at each site (%ΔdP/dtmax). There was no significant relationship between maximum %AdP/dtmax during LV stimulation at the best coronary sinus site and LV EF, baseline LV + dP/dt max, total LV Endo-AT, baseline QRS duration nor changes in QRS duration during LV pacing. However, the maximum %AdP/dtmax was significantly positively correlated with percentage area of late Endo-AT (r = 0.97, P < 0.001) and preserved LV myocardium (r = 0.81, P = 0.005), respectively. Patients with >20% of LV area with late Endo-AT and >30% of preserved LV myocardium had five times better acute hemodynamic response with LV stimulation. Multivariate analysis snowed that only percentage area of late Endo-AT was independently correlated with %AdP/dtmax (P < 0.05). Conclusion: The presence of a larger amount of LV area with late Endo-AT and preserved LV myocardium measured by electromechanical mapping could identify patients who have better acute improvement in systolic performance during LV stimulation.en_US
dc.languageengen_US
dc.publisherWiley-Blackwell Publishing, Inc.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=1045-3873en_US
dc.relation.ispartofJournal of Cardiovascular Electrophysiologyen_US
dc.subject.meshAgeden_US
dc.subject.meshBundle-Branch Block - Complications - Diagnosis - Physiopathology - Therapyen_US
dc.subject.meshCardiac Pacing, Artificialen_US
dc.subject.meshCardiomyopathy, Dilated - Complications - Diagnosis - Physiopathology - Therapyen_US
dc.subject.meshElectrocardiographyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHeart Conduction System - Physiopathologyen_US
dc.subject.meshHeart Ventriclesen_US
dc.subject.meshHemodynamicsen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMyocardial Contractionen_US
dc.subject.meshPredictive Value Of Testsen_US
dc.subject.meshReaction Timeen_US
dc.subject.meshSystoleen_US
dc.subject.meshTime Factorsen_US
dc.titleArea of left ventricular regional conduction delay and preserved myocardium predict responses to cardiac resynchronization therapyen_US
dc.typeArticleen_US
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_US
dc.identifier.authorityTse, HF=rp00428en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1046/j.1540-8167.2005.40568.xen_US
dc.identifier.pmid16050824-
dc.identifier.scopuseid_2-s2.0-22244434499en_US
dc.identifier.hkuros100823-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-22244434499&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume16en_US
dc.identifier.issue7en_US
dc.identifier.spage690en_US
dc.identifier.epage695en_US
dc.identifier.isiWOS:000230291700003-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridTse, HF=7006070805en_US
dc.identifier.scopusauthoridLee, KLF=7501505962en_US
dc.identifier.scopusauthoridWan, SH=7202724280en_US
dc.identifier.scopusauthoridYu, Y=8565869900en_US
dc.identifier.scopusauthoridHoersch, W=6506965287en_US
dc.identifier.scopusauthoridPastore, J=7004338763en_US
dc.identifier.scopusauthoridZhu, Q=7403313024en_US
dc.identifier.scopusauthoridKenknight, B=7003747548en_US
dc.identifier.scopusauthoridSpinelli, J=7006648003en_US
dc.identifier.scopusauthoridLau, CP=7401968501en_US
dc.identifier.citeulike244511-

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