Acute Effects of Intraoperative Multisite Ventricular Pacing on Left Ventricular Function and Activation/Contraction Sequence in Patients with Depressed Ventricular Function

Saxon, Leslie A.; Kerwin, Walter F.; Cahalan, Michael K.; Kalman, Jonathan M.; Olgin, Jeeerey E.; Foster, Elyse; Schiller, Nelson B.; Shinbane, Jerold S.; Lesh, Michael D.; Merrick, Scot H.

doi:10.1111/j.1540-8167.1998.tb00862.x

Cited by 146 publications

(84 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Recent studies revealed a reverse remodeling in left ventricle with cardiac resynchronization therapy (Saxon et al 1998;Lau et al 2000;Stellbrink et al 2001;Sogaard et al 2002;Pitzalis et al 2002). However, changes in left atrial remodeling and effects on SEC have not been adequately evaluated.…”

mentioning

confidence: 99%

Effect of Cardiac Resynchronization Therapy on Left Atrial Reverse Remodeling and Spontaneous Echo Contrast

Vural

Ağaçdiken

Ural

et al. 2004

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

Recent studies revealed reverse remodeling in left ventricle with cardiac resynchronization therapy (CRT). However, effects on left atrial remodeling, left atrial total emptying fraction and left atrial spontaneous echo contrast (SEC) have not been adequately evaluated. The aim of this study was to investigate the long-term changes in SEC, left atrial reverse remodeling, and left atrial total emptying fraction after CRT. Twenty patients with systolic heart failure and complete left bundle-branch block underwent implantation of biventricular pacemaker devices. Transthoracic and transesophageal echocardiography were performed one week before and one and six months after pacemaker implantation. After biventricular pacemaker implantation, significant clinical improvement was observed in all patients. Left atrial maximal and minimal volumes showed a significant progressive decline after CRT (reverse remodeling). Left atrial total emptying ejection fraction (LATEF) was 33±19% at baseline and increased to 37±10% and 41±11% at the 1st and 6th months respectively (p=0.01 and p=0.04). SEC was detected in 18 of 20 patients (90%) at the beginning of the study. After six months SEC disappeared in 5 patients and frequency of SEC reduced to 45%. Decrease in the intensity of the SEC was also statistically significant (at the 1st and 6th months; p=0.001 and p<0.001 respectively). Long-term CRT results in atrial reverse remodeling, increases LATEF, and reduces both frequency and intensity of atrial SEC. cardiac resynchronization; atrial reverse remodeling; SEC

show abstract

mentioning

confidence: 99%

Effect of Cardiac Resynchronization Therapy on Left Atrial Reverse Remodeling and Spontaneous Echo Contrast

Vural

Ağaçdiken

Ural

et al. 2004

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

show abstract

“…Another significant reference is the DAVID Trial [9]. Several other papers appeared about dual-chamber pacing applied to congestive heart failure during the last decade of the former century; in fact and without expressly saying it, all aimed at correcting rightleft ventricular dyssynchrony, but mostly centering the criterion on the A-V delay [10][11][12][13][14][15][16][17][18][19]. Observe that the last reference comes from a multicenter clinical study, and it is over 17-years-old.…”

Section: Discussionmentioning

confidence: 99%

Why Cardiac Resynchronization Therapy (CRT) is Usually Prescribed along with Automatic Implantable Defibrillation (AID)? Is it a Sensible Decision? Historical Perspective

Valentinuzzi¹

2017

Int J Clin Cardiol

View full text Add to dashboard Cite

“…These conduction disturbances produce suboptimal ventricular filling, a reduction in ventricular dP/dt, prolonged duration of mitral regurgitation, and ventricular dyssynchrony (seen as abnormal or paradoxical septal wall motion), which may further impair the pumping ability of the heart. [61][62][63][64] In the presence of a long AV delay and/or an IVCD, LV activation is delayed, but atrial activation is not. Hence, both early passive LV filling and the atrial kick may occur simultaneously, resulting in deceased total transmitral blood flow and diminished preloading of the left ventricle.…”

Section: P Pe Er Rm Ma An Ne En Nt T Pmentioning

confidence: 99%

Therapeutic Strategies for Diastolic Dysfunction: A Clinical Perspective

2009

J Cardiovasc Ultrasound

View full text Add to dashboard Cite

I In nt tr ro od du uc ct ti io on nDespite the fact that up to 50% of heart failure patients have preserved left ventricular (LV) systolic function, treatment of diastolic heart failure remains largely empiric because there have been no large scale randomized trials evaluating the effects of specific pharmacological agents. Nonpharmacologic, pharmacologic and surgical approaches are available, although its efficacy has not been proven. Treatment should target the underlying pathological condition that causes the diastolic heart failure. For example, coronary artery disease, hypertensive heart disease, hypertrophic obstructive cardiomyopathy, and constrictive pericarditis provide relatively specific therapeutic targets, such as lowering of blood pressure, regression of hypertrophy and fibrosis, and treatment of ischemia, and a complete removal of constricting pericardium. Theoretically, pharmacological agents that facilitate myocardial relaxation and improve LV compliance would be ideal for the treatment of diastolic dysfunction. As a shortterm therapeutic goal, manipulation of the loading conditions (preload, afterload) and control of the heart rate will be crucial. The treatment of underlying condition (e.g. hypertension) should be the ultimate goal for the treatment of LV diastolic dysfunction. Many of the drugs used for the treatment of symptoms of heart failure due to diastolic dysfunction are similar to those of systolic dysfunction, although the rationale for their use, the pathophysiological process that is being altered by the drug, and the dosing regimen may be entirely different. In this review, several therapeutic modalities including pharmacologic, nonpharmacologic, and surgical approaches for primary diastolic heart failure will be discussed. P Ph ha ar rm ma ac co ol lo og gi ic c T Th he er ra ap py y Angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor blockersACE-inhibitors and angiotensin II receptor blockers show not only an effect on blood pressure but elicit a direct effect on the myocardium via the local renin-angiotensin system. These effects are essential for the regression of LV hypertrophy, and the improvement in the elastic properties of the myocardium. 1)2) Several studies have documented that LV hypertrophy is more effectively reduced by ACE inhibitors than by other antihypertensive drugs, 3)4) suggesting an effect on myocardial structure beyond that provided by the reduction of pressure overload. Experimental and clinical studies suggest that the interaction of angiotensin II with its type 1 (AT1) receptors plays a critical role in alterations of collagen type I metabolism and development of myocardial fibrosis in arterial hypertension. Myocardial fibrosis is responsible for an increase in intrinsic myocardial stiffness that may alter the LV diastolic properties. Chronic activation of the reninangiotensin-aldosterone system has been shown to increase extracellular matrix fibrillar collagen and to be associated

show abstract

Acute Effects of Intraoperative Multisite Ventricular Pacing on Left Ventricular Function and Activation/Contraction Sequence in Patients with Depressed Ventricular Function

Cited by 146 publications

References 12 publications

Effect of Cardiac Resynchronization Therapy on Left Atrial Reverse Remodeling and Spontaneous Echo Contrast

Effect of Cardiac Resynchronization Therapy on Left Atrial Reverse Remodeling and Spontaneous Echo Contrast

Why Cardiac Resynchronization Therapy (CRT) is Usually Prescribed along with Automatic Implantable Defibrillation (AID)? Is it a Sensible Decision? Historical Perspective

Therapeutic Strategies for Diastolic Dysfunction: A Clinical Perspective

Contact Info

Product

Resources

About