A Study on Global Longitudinal Strain in Predicting Pacing Induced Left Ventricular Dysfunction Over Time in Post Permanent Pacemaker Patients

Abstract

OBJECTIVE:The goal of this study is to predict the long term LV function in RV apical paced patients. BACKGROUND:We have used the GLS measured by 2D STE, as a tool to predict the patients who are at high risk of developing pacing induced LV dysfunction (PIVD) or pacing induced cardiomyopathy (PCMP). METHOD: A prospective study conducted in the cardiology department of Government Rajaji Hospital, Madurai, including 47 patients of AV block or sinus node dysfunction with preserved ejection fraction undergoing RV apical pacing. This study population was followed up with serial trans thoracic 2D echocardiography with GLS by STE for a period of 12 months for the development of PIVD (PCMP). RESULTS: Of the study population, 42.5% (n=20) developed PIVD at 12 months and these patients had a signicant fall in their GLS values at one month post pacing. (GLS -16.94% vs -17.60%; p=0.02). CONCLUSION: GLS, a novel echocardiographic parameter can be used as a tool in predicting the decline in ejection fraction following pacemaker implantation with potential to predict the development of PIVD. GLS at one month post pacing had a high predictive accuracy for identifying those who developed PIVD later in the follow up.

What kind of interactions we may get moving from zwitter to “dritter” ions: C–O⋯Re(O4) and Re–O⋯Re(O4) anion⋯anion interactions make structural difference between l-histidinium perrhenate and pertechnetate

“…A deviation of χ 21 and χ 22 angles from 90°and χ 1 from 60°may be due to the participation of the imidazole rings in H-bonds and is also observed in other compounds such as L-histidinium tetrafluoroborate. 38 The imidazole groups of L-histidinium are in a trans conformation, and χ [C_1-C_2-C_3-C_4] values are close to 180°, which may provide higher availability of these groups to receptor interactions.…”

“…An example of this surface for 1 is illustrated in Since the perchlorate anion has a structure similar to perrhenate and pertechnetate, Hirshfeld surfaces were constructed for the two histidinium perchlorates found in different space groups (GASKAM(P2 1 ); 53 BOWJUT (Pbca) 54 ). To elucidate the role of oxygen in tetraoxoanions, an additional Hirshfeld surface was constructed for histidinium tetrafluoroborate (YEFPUV 38 ). For the latter, only a structure of acceptable quality was chosen.…”

“…The brightest red spots correspond to the strongest hydrogen bonds of the N-H⋯O type.Since the perchlorate anion has a structure similar to perrhenate and pertechnetate, Hirshfeld surfaces were constructed for the two histidinium perchlorates found in different space groups (GASKAM(P2 1 ); 53 BOWJUT (Pbca)54 ). To elucidate the role of oxygen in tetraoxoanions, an additional Hirshfeld surface was constructed for histidinium tetrafluoroborate (YEFPUV38 ). For the latter, only a structure of acceptable quality was chosen.The main contribution to noncovalent interactions in cations and anions is made by contacts of the O(F)⋯H/ H⋯O(F) type, which are usually responsible for hydrogen bonds (Fig.5 and 6).…”

Characterizing Adeno-Associated Virus Capsids with both Denaturing and Intact Analysis Methods

“…Characterization of PTMs is important because they could have implications to the overall functionality and stability of AAV formulations. 44,45…”