Effect of Left Ventricular Dyssynchrony on Cardiac Sympathetic Activity in Heart Failure Patients With Wide QRS Duration
2011; Japanese Circulation Society; Volume: 76; Issue: 2 Linguagem: Inglês
10.1253/circj.cj-11-0752
ISSN1347-4820
AutoresHidekazu Tanaka, Kazuhiro Tatsumi, Sei Fujiwara, Takayuki Tsuji, Akihiro Kaneko, Keiko Ryo, Yuko Fukuda, Kensuke Matsumoto, Mayumi Shigeru, Akihiro Yoshida, Hiroya Kawai, Ken–ichi Hirata,
Tópico(s)ECG Monitoring and Analysis
ResumoDyssynchrony has various detrimental effects on cardiac function, but its effect on cardiac sympathetic activity is not fully understood.We studied 50 heart failure patients who underwent cardiac resynchronization therapy (CRT). Cardiac sympathetic activity was assessed by (123)I-metaiodobenzylguanidine ((123)I-MIBG) scintigraphy as the delayed heart-to-mediastinum ratio (H/M ratio). Echocardiography was performed before and 7 months after CRT, and response was defined as a ≥15% decrease in end-systolic volume. Dyssynchrony was determined by the time difference between the anteroseptal-to-posterior wall using speckle-tracking radial strain (≥130 ms predefined as significant). H/M ratio in patients with dyssynchrony was less than that in patients without dyssynchrony (1.62 ± 0.31 vs. 1.82 ± 0.36, P<0.05), even though ejection fraction was not significantly different (24 ± 6% vs. 25 ± 7%). Patients with dyssynchrony and H/M ratio ≥1.6 had a higher frequency of response to CRT (94%) and favorable long-term outcome over 3.0 years. In contrast, patients without dyssynchrony and H/M ratio <1.6 were more likely to show a lower frequency of response to CRT (0%) and unfavorable long-term outcome after CRT.Dyssynchrony is associated with cardiac sympathetic activity, and (123)I-MIBG scintigraphy may be valuable for predicting the response to CRT.
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