| Myocardial perfusion and adrenergic innervation in patients with RBBB and LAfB: the effect of altering the activation sequence with right ventricular apical pacing. | |
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MedLine Citation:
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PMID: 12765447 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The aim of this study was to investigate myocardial perfusion and adrenergic innervation in patients with intraventricular conduction disturbances and to detect any changes caused by alteration of the ventricular activation sequence as a result of right ventricular apical pacing. We studied 15 patients with right bundle branch block (RBBB) and left anterior fascicular block (LAFB), while 15 healthy individuals served as controls. All patients underwent planar and single-photon emission computed tomography (SPECT) myocardial imaging after intravenous infusion of 5mCi 123I-metaiodobenzylguanidine (123I-MIBG) and a SPECT thallium201 myocardial perfusion study before and 3 months after pacemaker implantation. The heart to mediastinum ratio was calculated during the 123I-MIBG study in order to assess the global cardiac sympathetic activity and was significantly smaller in patients than in controls (P < 0.001). Patients with RBBB and LAFB revealed regional adrenergic innervation defects, mostly in the inferior and posterior walls. After a medium-term pacing period, a redistribution of 123I-MIBG uptake was detected, with aggravation of adrenergic innervation defects in the apical and posterior walls and amelioration in septal and anterior walls. Five patients showed perfusion defects that remained unchanged after pacing. Two others displayed mild myocardial perfusion defects that did not exist before pacing. In conclusion, patients with RBBB and LAFB reveal global and regional disturbances of myocardial adrenergic innervation, which shows redistribution as a result of the altered propagation of the ventricular electrical activation. To a smaller degree these patients reveal myocardial perfusion disturbances in which pacing has a limited medium-term effect. |
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Authors:
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Emmanuel N Simantirakis; Vasilios K Prassopoulos; Maria E Marketou; Stavros I Chrysostomakis; Sophia I Koukouraki; John P Lekakis; Nikolaos S Karkavitsas; Panos E Vardas |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pacing and clinical electrophysiology : PACE Volume: 26 ISSN: 0147-8389 ISO Abbreviation: Pacing Clin Electrophysiol Publication Date: 2003 May |
Date Detail:
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Created Date: 2003-05-26 Completed Date: 2003-10-02 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7803944 Medline TA: Pacing Clin Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 1202-7 Citation Subset: IM |
Affiliation:
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Cardiology Department, University Hospital of Heraklion, Crete, Greece. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Analysis of Variance Bundle-Branch Block / physiopathology, radionuclide imaging*, therapy* Case-Control Studies Coronary Circulation* Female Heart Ventricles / innervation*, physiopathology, radionuclide imaging Humans Iodine Radioisotopes / diagnostic use Male Middle Aged Pacemaker, Artificial* Prospective Studies Radiopharmaceuticals / diagnostic use Thallium Radioisotopes / diagnostic use Tomography, Emission-Computed, Single-Photon |
| Chemical | |
Reg. No./Substance:
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0/Iodine Radioisotopes; 0/Radiopharmaceuticals; 0/Thallium Radioisotopes |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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