Document Detail

Hemodynamic improvement in cardiac resynchronization does not require improvement in left ventricular rotation mechanics: three-dimensional tagged MRI analysis.
MedLine Citation:
PMID:  20478988     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Earlier studies have yielded conflicting evidence on whether or not cardiac resynchronization therapy (CRT) improves left ventricular (LV) rotation mechanics.
METHODS AND RESULTS: In dogs with left bundle branch block and pacing-induced heart failure (n=7), we studied the effects of CRT on LV rotation mechanics in vivo by 3-dimensional tagged magnetic resonance imaging with a temporal resolution of 14 ms. CRT significantly improved hemodynamic parameters but did not significantly change the LV rotation or rotation rate. LV torsion, defined as LV rotation of each slice with respect to that of the most basal slice, was not significantly changed by CRT. CRT did not significantly change the LV torsion rate. There was no significant circumferential regional heterogeneity (anterior, lateral, inferior, and septal) in LV rotation mechanics in either left bundle branch block with pacing-induced heart failure or CRT, but there was significant apex-to-base regional heterogeneity.
CONCLUSIONS: CRT acutely improves hemodynamic parameters without improving LV rotation mechanics. There is no significant circumferential regional heterogeneity of LV rotation mechanics in the mechanically dyssynchronous heart. These results suggest that LV rotation mechanics is an index of global LV function, which requires coordination of all regions of the left ventricle, and improvement in LV rotation mechanics appears to be a specific but insensitive index of acute hemodynamic response to CRT.
Hiroshi Ashikaga; Christophe Leclercq; Jiangxia Wang; David A Kass; Elliot R McVeigh
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-05-17
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  3     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-21     Completed Date:  2010-08-12     Revised Date:  2014-09-09    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  456-63     Citation Subset:  IM    
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MeSH Terms
Analysis of Variance
Biomechanical Phenomena
Bundle-Branch Block / physiopathology*,  therapy*
Cardiac Pacing, Artificial
Disease Models, Animal
Heart Failure / physiopathology*,  therapy*
Image Processing, Computer-Assisted
Imaging, Three-Dimensional*
Magnetic Resonance Imaging, Cine / methods*
Ventricular Dysfunction, Left / physiopathology*,  therapy*
Grant Support
P01 HL077180/HL/NHLBI NIH HHS; P01 HL077180-01/HL/NHLBI NIH HHS; P01-HL077180/HL/NHLBI NIH HHS; P50 HL052307/HL/NHLBI NIH HHS; P50 HL052307-080007/HL/NHLBI NIH HHS; P50-HL52307/HL/NHLBI NIH HHS; Z01 HL004609-04/HL/NHLBI NIH HHS; Z01-HL004609/HL/NHLBI NIH HHS

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