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Atrioventricular left ventricular apical pacing improves haemodynamic, rotational, and deformation variables in comparison to pacing at the lateral wall in intact myocardium: experimental study.

Toumanidis S, Kaladaridou A, Bramos D, Skaltsiotes E, Agrios J, Pamboucas C, Kottis G, Antoniou A, Papadopoulou E, Moulopoulos S - Cardiol Res Pract (2014)

Bottom Line: Methods.Results.In pig hearts with intact myocardium, LV function is maintained at sinus rhythm level when AV pacing is performed at the LV apex.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Therapeutics, Medical School, National and Kapodistrian University of Athens, "Alexandra" Hospital, 80 Vas. Sofias Avenue, 11528 Athens, Greece.

ABSTRACT
Aim. To assess the effect on left ventricular (LV) function of atrioventricular (AV) and ventricular pacing at the LV apical or lateral wall and to compare the normal torsional and deformation pattern of the intact LV myocardium with those created by the aforementioned LV pacing modes and sites. Methods. Experiments were conducted in pigs (n = 21) with normal LV function to investigate the acute hemodynamic effects of epicardial AV and ventricular LV pacing at the LV apical or lateral wall. Torsional and deformation indices of LV function were assessed using speckle tracking echocardiography. Results. AV pacing at the apex revealed a significant reduction in the radial strain of the base (P < 0.03), without affecting significantly the ejection fraction and the LV torsion or twist. In contrast, AV pacing at the lateral wall produced, in addition to the reduction of the radial strain of the base (P < 0.01), significant reduction of the circumferential and the radial strain of the apex (both P < 0.01) as well as of the ejection fraction (P < 0.002) and twist (P < 0.05). Conclusions. In pig hearts with intact myocardium, LV function is maintained at sinus rhythm level when AV pacing is performed at the LV apex.

No MeSH data available.


Related in: MedlinePlus

A representative case of left ventricular (LV) twist (8.94°) in sinus rhythm. The white color tracing denotes LV twist; blue denotes apical rotation (4.75°); purple denotes basal rotation. AVC: aortic valve closure.
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fig1: A representative case of left ventricular (LV) twist (8.94°) in sinus rhythm. The white color tracing denotes LV twist; blue denotes apical rotation (4.75°); purple denotes basal rotation. AVC: aortic valve closure.

Mentions: Epicardial pacing of intact myocardium revealed impairment for LV function in comparison to sinus rhythm. Specifically, there were significant decreases in the LV indices of systolic function, SV, EF, LV systolic pressure (all P < 0.001), dP/dtmax⁡ (P = 0.005), and the eccentricity index Ld/Sd (P = 0.02); in contrast, ESV (P < 0.05) and the diastolic function index e/e′ ratio, which denotes an elevated LV filling pressure (P = 0.04), increased significantly; dP/dtmin⁡, which denotes ventricular lucitropy, decreased significantly (P < 0.001), (Table 1). Moreover, the torsional parameters (Figures 1 and 2), twist (P < 0.001) and torsion (P = 0.002), and apical rotation (P = 0.002) and apical peak systolic rotation rate (P = 0.005), as well as the deformation variables, radial strain of the apex (P < 0.01) and the base (P = 0.004), together with circumferential strain of the apex (P < 0.001) and the base (P = 0.02), deteriorated significantly (Table 2, Figure 3).


Atrioventricular left ventricular apical pacing improves haemodynamic, rotational, and deformation variables in comparison to pacing at the lateral wall in intact myocardium: experimental study.

Toumanidis S, Kaladaridou A, Bramos D, Skaltsiotes E, Agrios J, Pamboucas C, Kottis G, Antoniou A, Papadopoulou E, Moulopoulos S - Cardiol Res Pract (2014)

A representative case of left ventricular (LV) twist (8.94°) in sinus rhythm. The white color tracing denotes LV twist; blue denotes apical rotation (4.75°); purple denotes basal rotation. AVC: aortic valve closure.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3934323&req=5

fig1: A representative case of left ventricular (LV) twist (8.94°) in sinus rhythm. The white color tracing denotes LV twist; blue denotes apical rotation (4.75°); purple denotes basal rotation. AVC: aortic valve closure.
Mentions: Epicardial pacing of intact myocardium revealed impairment for LV function in comparison to sinus rhythm. Specifically, there were significant decreases in the LV indices of systolic function, SV, EF, LV systolic pressure (all P < 0.001), dP/dtmax⁡ (P = 0.005), and the eccentricity index Ld/Sd (P = 0.02); in contrast, ESV (P < 0.05) and the diastolic function index e/e′ ratio, which denotes an elevated LV filling pressure (P = 0.04), increased significantly; dP/dtmin⁡, which denotes ventricular lucitropy, decreased significantly (P < 0.001), (Table 1). Moreover, the torsional parameters (Figures 1 and 2), twist (P < 0.001) and torsion (P = 0.002), and apical rotation (P = 0.002) and apical peak systolic rotation rate (P = 0.005), as well as the deformation variables, radial strain of the apex (P < 0.01) and the base (P = 0.004), together with circumferential strain of the apex (P < 0.001) and the base (P = 0.02), deteriorated significantly (Table 2, Figure 3).

Bottom Line: Methods.Results.In pig hearts with intact myocardium, LV function is maintained at sinus rhythm level when AV pacing is performed at the LV apex.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Therapeutics, Medical School, National and Kapodistrian University of Athens, "Alexandra" Hospital, 80 Vas. Sofias Avenue, 11528 Athens, Greece.

ABSTRACT
Aim. To assess the effect on left ventricular (LV) function of atrioventricular (AV) and ventricular pacing at the LV apical or lateral wall and to compare the normal torsional and deformation pattern of the intact LV myocardium with those created by the aforementioned LV pacing modes and sites. Methods. Experiments were conducted in pigs (n = 21) with normal LV function to investigate the acute hemodynamic effects of epicardial AV and ventricular LV pacing at the LV apical or lateral wall. Torsional and deformation indices of LV function were assessed using speckle tracking echocardiography. Results. AV pacing at the apex revealed a significant reduction in the radial strain of the base (P < 0.03), without affecting significantly the ejection fraction and the LV torsion or twist. In contrast, AV pacing at the lateral wall produced, in addition to the reduction of the radial strain of the base (P < 0.01), significant reduction of the circumferential and the radial strain of the apex (both P < 0.01) as well as of the ejection fraction (P < 0.002) and twist (P < 0.05). Conclusions. In pig hearts with intact myocardium, LV function is maintained at sinus rhythm level when AV pacing is performed at the LV apex.

No MeSH data available.


Related in: MedlinePlus