Abstract:
PURPOSE:Right ventricular (RV) performance is known to have prognostic value in patients with congestive heart failure (CHF). Cardiac resynchronization therapy (CRT) has been found to enhance left ventricular (LV) energetics and metabolic reserve in patients with heart failure. The interplay between the LV and RV may play an important role in CRT response. The purpose of the study was to investigate RV oxidative metabolism, metabolic reserve and the effects of CRT in patients with CHF and left bundle brach block. In addition, the role of the RV in the response to CRT was evaluated. METHODS:Ten patients with idiopathic dilated cardiomyopathy who had undergone implantation of a biventricular pacemaker 8+/-5 months earlier were studied under two conditions: CRT ON and after CRT had been switched OFF for 24 h. Oxidative metabolism was measured using [11C]acetate positron emission tomography (Kmono). The measurements were performed at rest and during dobutamine-induced stress (5 microg/kg per minute). LV performance and interventricular mechanical delay (interventricular asynchrony) were measured using echocardiography. RESULTS:CRT had no effect on RV Kmono at rest (ON: 0.052+/-0.014, OFF: 0.047+/-0.018, NS). Dobutamine-induced stress increased RV Kmono significantly under both conditions but oxidative metabolism was more enhanced when CRT was ON (0.076+/-0.026 vs 0.065+/-0.027, p=0.003). CRT shortened interventricular delay significantly (45+/-33 vs 19+/-35 ms, p=0.05). In five patients the response to CRT was striking (32% increase in mean LV stroke volume, range 18-36%), while in the other five patients no response was observed (mean change +2%, range -6% to +4%). RV Kmono and LV stroke volume response to CRT correlated inversely (r=-0.66, p=0.034). None of the other measured parameters, including all LV parameters and electromechanical parameters, were associated with the response to CRT. In responders, RV Kmono with CRT OFF was significantly lower than in non-responders (0.036+/-0.01 vs 0.058+/-0.02, p=0.047). CONCLUSION:CRT appears to enhance RV oxidative metabolism and metabolic reserve during stress. Patients responding to CRT appear to have lower RV oxidative metabolism at rest, suggesting that the RV plays a significant role in the response to CRT.
journal_name
Eur J Nucl Med Mol Imagingauthors
Knuuti J,Sundell J,Naum A,Engblom E,Koistinen J,Ylitalo A,Stolen KQ,Kalliokoski R,Nekolla SG,Bax KE,Airaksinen KEdoi
10.1007/s00259-004-1631-9subject
Has Abstractpub_date
2004-12-01 00:00:00pages
1592-8issue
12eissn
1619-7070issn
1619-7089journal_volume
31pub_type
临床试验,杂志文章abstract::Oesophageal scintigraphy has been used for more than 25 years and allows quantifiable, safe, rapid, non-invasive and well-tolerated assessment of oesophageal transit time and function. As technology improves, more complex image analysis is becoming possible. Many studies have addressed its usefulness in assessing oeso...
journal_title:European journal of nuclear medicine and molecular imaging
pub_type: 杂志文章,评审
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abstract:PURPOSE:To determine if PET reporting criteria for the Response Adapted Treatment in Hodgkin Lymphoma (RATHL) trial could enable satisfactory agreement to be reached between 'core' laboratories operating in different countries. METHODS:Four centres reported scans from 50 patients with stage II-IV HL, acquired before a...
journal_title:European journal of nuclear medicine and molecular imaging
pub_type: 杂志文章
doi:10.1007/s00259-010-1490-5
更新日期:2010-10-01 00:00:00
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journal_title:European journal of nuclear medicine and molecular imaging
pub_type: 杂志文章
doi:10.1007/s00259-017-3846-6
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journal_title:European journal of nuclear medicine and molecular imaging
pub_type: 杂志文章,评审
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journal_title:European journal of nuclear medicine and molecular imaging
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journal_title:European journal of nuclear medicine and molecular imaging
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journal_title:European journal of nuclear medicine and molecular imaging
pub_type: 杂志文章,评审
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journal_title:European journal of nuclear medicine and molecular imaging
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journal_title:European journal of nuclear medicine and molecular imaging
pub_type: 临床试验,杂志文章
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journal_title:European journal of nuclear medicine and molecular imaging
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 nuclear medicine and molecular imaging
pub_type: 杂志文章
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journal_title:European journal of nuclear medicine and molecular imaging
pub_type: 临床试验,杂志文章
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journal_title:European journal of nuclear medicine and molecular imaging
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pub_type: 临床试验,杂志文章
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pub_type: 杂志文章
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更新日期:2004-12-01 00:00:00
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pub_type: 临床试验,杂志文章
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journal_title:European journal of nuclear medicine and molecular imaging
pub_type: 杂志文章
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journal_title:European journal of nuclear medicine and molecular imaging
pub_type: 杂志文章
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更新日期:2020-05-01 00:00:00
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journal_title:European journal of nuclear medicine and molecular imaging
pub_type: 杂志文章
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更新日期:2010-08-01 00:00:00
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