Abstract:
BACKGROUND:Biventricular (BiV) pacing has been found to improve systolic function and exercise tolerance in patients with severe congestive heart failure and bundle branch block. The mechanisms behind this beneficial effect is still not sufficiently clarified. AIM:To evaluate the regional myocardial perfusion (MP) during BiV pacing and after acute change of the pacing mode to conventional dual chamber (DDD) pacing, and single chamber atrial (AAI) pacing in patients with severe congestive heart failure and prolonged QRS width treated with chronic BiV pacing. METHODS AND RESULTS:Fourteen patients (age 63+/-7 years, 13 male) were evaluated 13+/-7 months after implantation of a triple-chamber biventricular pacemaker. MP was quantified with 13N-labeled ammonia positron emission tomography during BiV pacing, DDD pacing, and AAI pacing. MP was assessed in the anterior, lateral, inferior, and septal regions, and the global mean MP was calculated. Clinical assessment was performed before pacemaker implantation and after at least 3 months of BiV pacing including a 6-min walk test (WT), New York Heart Association (NYHA) class functional score and echocardiography. Global mean MP (BiV: 0.65+/-0.20 vs. DDD: 0.65+/-0.21 vs. AAI: 0.65+/-0.18 mlg(-1)min(-1)) and MP in each of the four regions did not differ between the three pacing modes. The patients improved clinically during BiV pacing; 6 min WT increased (338+/-59 vs. 415+/-73 m, P<0.001), NYHA class score improved (class I/II/III/IV: 0/0/11/3 vs. 1/9/2/0, P<0.001), and left ventricular ejection fraction increased (21+/-5 vs. 29+/-8%, P=0.004). CONCLUSION:No differences in regional MP are detectable after chronic BiV pacing when the pacing mode is changed acutely in patients with severe congestive heart failure and bundle branch block. This finding indicates, that the clinical improvement caused by BiV pacing is not associated with any increase in the MP and thereby oxygen demand.
journal_name
Eur J Heart Failjournal_title
European journal of heart failureauthors
Nielsen JC,Bøttcher M,Jensen HK,Nielsen TT,Pedersen AK,Mortensen PTdoi
10.1016/s1388-9842(02)00245-3keywords:
subject
Has Abstractpub_date
2003-03-01 00:00:00pages
179-86issue
2eissn
1388-9842issn
1879-0844pii
S1388984202002453journal_volume
5pub_type
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journal_title:European journal of heart failure
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journal_title:European journal of heart failure
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ejheart.2008.10.004
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journal_title:European journal of heart failure
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journal_title:European journal of heart failure
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journal_title:European journal of heart failure
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journal_title:European journal of heart failure
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pub_type: 杂志文章,随机对照试验
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journal_title:European journal of heart failure
pub_type: 临床试验,杂志文章
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journal_title:European journal of heart failure
pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章
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journal_title:European journal of heart failure
pub_type: 杂志文章,评审
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journal_title:European journal of heart failure
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:European journal of heart failure
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:European journal of heart failure
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:European journal of heart failure
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