Myocardial oxygen consumption and perfusion before and after cardiac resynchronization therapy: experimental observations and clinical implications*1

Baller, D.; Vogt, Jürgen; Lindner, Oliver; Lamp, Barbara; Holzinger, Jens; Kammeier, Annett; Wielepp, Peter; Burchert, Wolfgang; Horstkotte, Dieter

doi:10.1016/j.ehjsup.2004.05.001

Cited by 6 publications

(27 citation statements)

References 31 publications

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“…There is a lot of controversy on regional myocardial perfusion in patients with ventricular conduction abnormalities, which may be attributed to the use of different imaging modalities, radiopharmaceuticals, study protocols, and approaches for flow assessment. The study by Baller et al showed a low absolute MBF in the septal and high MBF in the lateral wall using 11 C-acetate, while the study of Koepfli et al showed a more homogeneous perfusion at rest using 15 O-water [18, 19]. In the latter study, regional perfusion inhomogeneity was observed only during stress imaging which could be explained by the fact that ‘stress’ increases the imbalance in regional mechanical work resulting in higher regional perfusion changes [20].…”

Section: Discussionmentioning

confidence: 99%

Low septal to lateral wall 18F-FDG ratio is highly associated with mechanical dyssynchrony in non-ischemic CRT candidates

et al. 2019

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BackgroundIn order to better understand the concept of mechanical dyssynchrony, a promising hallmark of cardiac resynchronization therapy (CRT) response, we investigated its effect on regional myocardial metabolism and myocardial blood flow (MBF) in non-ischemic CRT candidates.ResultsThirty consecutive non-ischemic CRT eligible patients underwent static 18F-FDG and resting dynamic 13N-NH3 PET/CT. 18F-FDG uptake and MBF for septal and lateral wall were analysed and septal-to-lateral wall ratios (SLR) were calculated. Based on the presence of mechanical dyssynchrony (septal flash and/or apical rocking) on echocardiography, patients were divided into 2 groups, with (n = 23) and without (n = 7) mechanical dyssynchrony.Patients with mechanical dyssynchrony had significantly lower 18F-FDG SUVmean in the septum compared with the lateral wall (5.58 ± 2.65 vs 11.19 ± 4.10, p < 0.0001), while patients without mechanical dyssynchrony had a more homogeneous 18F-FDG distribution (7.33 ± 2.88 vs 8.31 ± 2.50, respectively, p = 0.30). Similarly, MBF was significantly different between the septal and lateral wall in the dyssynchrony group (0.57 ± 0.11 ml/g/min vs 0.92 ± 0.23 ml/g/min, respectively, p < 0.0001), whereas no difference was observed in the non-dyssynchrony group (0.61 ± 0.23 ml/g/min vs 0.77 ± 0.21 ml/g/min, respectively, p = 0.16). 18F-FDG SLR, but not MBF SLR, was associated with the presence of mechanical dyssynchrony and showed a significant inverse correlation with volumetric reverse remodeling after CRT (r = − 0.62, p = 0.001).ConclusionsNon-ischemic heart failure patients with mechanical dyssynchrony demonstrate heterogeneous regional metabolism and MBF compared with patients without dyssynchrony. However, only 18F-FDG SLR appeared to be highly associated with the presence of mechanical dyssynchrony.Trial registrationClinicaltrials, NCT02537782. Registered 2 September 2015.

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Section: Discussionmentioning

confidence: 99%

Low septal to lateral wall 18F-FDG ratio is highly associated with mechanical dyssynchrony in non-ischemic CRT candidates

et al. 2019

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“…Note the statistically significant reverse remodelling of regional myocardial oxygen consumption. (From reference [55], with permission). efficiency did not differ significantly between the three pacing modes [43].…”

Section: Myocardial O 2 Consumption and Cardiac Efficiencymentioning

confidence: 96%

“…Moreover, it improves regional oxidative metabolism and cardiac efficiency in the septum and decreases myocardial oxygen consumption and myocardial blood flow in the lateral wall, thus leading to a reverse remodelling of regional myocardial oxygen imbalance (Fig. 5) [51][52][53][54][55].…”

Section: Myocardial O 2 Consumption and Cardiac Efficiencymentioning

confidence: 97%

The effects of ventricular asynchrony on myocardial perfusion

Kyriakides

Manolis

Kolettis

2007

International Journal of Cardiology

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“…The clinical data demonstrating the energetic changes during the pacing on the patients with dilated cardiomyopathy were shown by Baller et al. ( 2004 ). Kerckhoffs et al.…”

Section: Introductionmentioning

confidence: 91%

Determination of myocardial energetic output for cardiac rhythm pacing

2007

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This research is aimed to the determination of the changes in the cardiac energetic output for three different modes of cardiac rhythm pacing. The clinical investigation of thirteen patients with the permanent dualchamber pacemaker implantation was carried out. The patients were taken to echocardiography examination conducted by way of three pacing modes (AAI, VVI and DDD). The myocardial energetic parameters-the stroke work index (SWI) and the myocardial oxygen consumption (MVO2) are not directly measurable, however, their values can be determined using the numerical model of the human cardiovascular system. The 24-segment hemodynamical model (pulsating type) of the human cardiovascular system was used for the numerical simulation of the changes of myocardial workload for cardiac rhythm pacing. The model was fitted by well-measurable parameters for each patient. The calculated parameters were compared using the two-tailed Student's test. The differences of SWI and MVO2 between the modes AAI and VVI and the modes DDD and VVI are statistically significant (P \ 0.05). On the other hand, the hemodynamic effects for the stimulation modes DDD and AAI are almost identical, i.e. the differences are statistically insignificant (P [ 0.05).

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Myocardial oxygen consumption and perfusion before and after cardiac resynchronization therapy: experimental observations and clinical implications*1

Cited by 6 publications

References 31 publications

Low septal to lateral wall 18F-FDG ratio is highly associated with mechanical dyssynchrony in non-ischemic CRT candidates

Low septal to lateral wall 18F-FDG ratio is highly associated with mechanical dyssynchrony in non-ischemic CRT candidates

The effects of ventricular asynchrony on myocardial perfusion

Determination of myocardial energetic output for cardiac rhythm pacing

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