| Physiological Relevance of Quantifying Segmental Contraction Synchrony. | |
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MedLine Citation:
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PMID: 22017611 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background: Most current indices of synchrony quantify left ventricular (LV) contraction pattern in terms of a single, global (integrated) measure. We report the development and physiological relevance of a novel method to quantify LV segmental contraction synchrony. Methods: LV pressure-volume and echocardiographic data were collected in seven anesthetized, opened-chest dogs under several pacing modes: right atrial (RA) (control), right ventricular (RV) (dyssynchrony), and additional LV pacing at either apex (CRTa) or free wall (CRTf). Cross-correlation-based integrated (CCSI(int) ) and segmental (CCSI(seg) ) measures of synchrony were calculated from speckle-tracking derived radial strain, along with a commonly used index (maximum time delay). LV contractility was quantified using either E(es) (ESPVR slope) or ESPVR(area) (defined in the manuscript). Results: RV pacing decreased CCSI(int) at LV base (0.95 ± 0.02 [RA] vs 0.64 ± 0.14 [RV]; P < 0.05) and only CRTa improved it (0.93 ± 0.03; P < 0.05 vs RV). The CCSI(seg) analysis identified anteroseptal and septal segments as being responsible for the low CCSI(int) during RV pacing and inferior segment for poor resynchronization with CRTf. Changes in ESPVR(area) , and not in E(es) , indicated depressed LV contractility with RV pacing, an observation consistent with significantly decreased global LV performance (stroke work [SW]: 252 ± 23 [RA] vs 151 ± 24 [RV] mJ; P < 0.05). Only CRTa improved SW and contractility (SW: 240 ± 19 mJ; ESPVR(area) : 545 ± 175 mmHg•mL; both P < 0.01 vs RV). Only changes in CCSI(seg) and global LV contractility were strongly correlated (R(2) = 0.698, P = 0.005). Conclusion: CCSI(seg) provided insights into the changes in LV integrated contraction pattern and a better link to global LV contractility changes. (PACE 2011; 1-14). |
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Authors:
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Lauren Johnson; Bouchra Lamia; Hyung Kook Kim; Masaki Tanabe; John Gorcsan; David Schwartzman; Sanjeev G Shroff; Michael R Pinsky |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-10-20 |
Journal Detail:
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Title: Pacing and clinical electrophysiology : PACE Volume: - ISSN: 1540-8159 ISO Abbreviation: - Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-10-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7803944 Medline TA: Pacing Clin Electrophysiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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©2011, The Authors. Journal compilation ©2011 Wiley Periodicals, Inc. |
Affiliation:
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Cardiovascular Systems Laboratory, Department of Bioengineering Cardiopulmonary Research Laboratory, Department of Critical Care Medicine Cardiovascular Institute McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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