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Severe mechanical dyssynchrony causes regional hibernation-like changes in pigs with nonischemic heart failure.

Abstract：

BACKGROUND:Sustained left ventricular (LV) dyssynchrony can lead to heart failure (HF) in the absence of coronary artery stenosis. We tested whether myocardial hibernation underlies the LV functional impairment caused by high-frequency pacing, an established model of nonischemic dilated cardiomyopathy. METHODS AND RESULTS:Regional LV contractile and perfusion reserve were assessed by magnetic resonance imaging, respectively, as end-systolic wall thickening (LVESWT) and myocardial perfusion reserve index (MPRI) at rest and during low-dose dobutamine stress (LDDS, 10 microg.kg.min intravenously for 10minutes) in failing minipigs (n=8). LV tissue was analyzed for glycogen deposits and other molecular hallmarks of hibernation. LDDS caused a marked increase in LVESWT (27+/-2.98 vs. 7.15+/-3 %, P < .05) and MPRI (2.1+/-0.5 vs. 1.3+/-0.3 P < .05) in the region that was activated first (pacing site) compared with the opposite region. Myocardial glycogen content was markedly increased in the pacing site (P < .05 vs. opposite region). In addition, gene expression of glycogen phosphorylase was reduced in pacing site compared with opposite regions (0.71+/-0.1 vs. 1.03+/-0.3, P < .05), whereas that of hexokinase type II was globally reduced by 83%. CONCLUSIONS:The combination of high heart rate and sustained dyssynchronous LV contraction causes asymmetrical myocardial hibernation, in absence of coronary artery stenosis.

journal_name

J Card Fail

journal_title

Journal of cardiac failure

authors

Lionetti V,Aquaro GD,Simioniuc A,Di Cristofano C,Forini F,Cecchetti F,Campan M,De Marchi D,Bernini F,Grana M,Nannipieri M,Mancini M,Lombardi M,Recchia FA,Pingitore A

doi

10.1016/j.cardfail.2009.06.436

subject

Has Abstract

pub_date

2009-12-01 00:00:00

pages

920-8

issue

10

eissn

1071-9164

issn

1532-8414

pii

S1071-9164(09)00627-7

journal_volume

15

pub_type

杂志文章

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