Mechanical Dyssynchrony in Dilated Cardiomyopathy With Intraventricular Conduction Delay as Depicted by 3D Tagged Magnetic Resonance Imaging
2000; Lippincott Williams & Wilkins; Volume: 101; Issue: 1 Linguagem: Inglês
10.1161/01.cir.101.1.e2
ISSN1524-4539
AutoresCecilia W. Curry, Gregg Nelson, Bradley T. Wyman, Jérôme Declerck, Maurice Talbot, Ronald D. Berger, Elliot R. McVeigh, David A. Kass,
Tópico(s)Cardiac Arrhythmias and Treatments
ResumoHomeCirculationVol. 101, No. 1Mechanical Dyssynchrony in Dilated Cardiomyopathy With Intraventricular Conduction Delay as Depicted by 3D Tagged Magnetic Resonance Imaging Free AccessOtherPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissionsDownload Articles + Supplements ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toSupplemental MaterialFree AccessOtherPDF/EPUBMechanical Dyssynchrony in Dilated Cardiomyopathy With Intraventricular Conduction Delay as Depicted by 3D Tagged Magnetic Resonance Imaging Cecilia W. Curry, Gregory S. Nelson, Bradley T. Wyman, Jerome Declerck, Maurice Talbot, Ronald D. Berger, Elliot R. McVeigh and David A. Kass Cecilia W. CurryCecilia W. Curry From the Division of Cardiology, the Department of Medicine (C.W.C., G.S.N., M.T., R.D.B., D.A.K.), the Department of Biomedical Engineering (B.T.W., J.D., E.R.M., D.A.K.), and the Department of Radiology (E.R.M.), The Johns Hopkins Medical Institutions, Baltimore, Md. , Gregory S. NelsonGregory S. Nelson From the Division of Cardiology, the Department of Medicine (C.W.C., G.S.N., M.T., R.D.B., D.A.K.), the Department of Biomedical Engineering (B.T.W., J.D., E.R.M., D.A.K.), and the Department of Radiology (E.R.M.), The Johns Hopkins Medical Institutions, Baltimore, Md. , Bradley T. WymanBradley T. Wyman From the Division of Cardiology, the Department of Medicine (C.W.C., G.S.N., M.T., R.D.B., D.A.K.), the Department of Biomedical Engineering (B.T.W., J.D., E.R.M., D.A.K.), and the Department of Radiology (E.R.M.), The Johns Hopkins Medical Institutions, Baltimore, Md. , Jerome DeclerckJerome Declerck From the Division of Cardiology, the Department of Medicine (C.W.C., G.S.N., M.T., R.D.B., D.A.K.), the Department of Biomedical Engineering (B.T.W., J.D., E.R.M., D.A.K.), and the Department of Radiology (E.R.M.), The Johns Hopkins Medical Institutions, Baltimore, Md. , Maurice TalbotMaurice Talbot From the Division of Cardiology, the Department of Medicine (C.W.C., G.S.N., M.T., R.D.B., D.A.K.), the Department of Biomedical Engineering (B.T.W., J.D., E.R.M., D.A.K.), and the Department of Radiology (E.R.M.), The Johns Hopkins Medical Institutions, Baltimore, Md. , Ronald D. BergerRonald D. Berger From the Division of Cardiology, the Department of Medicine (C.W.C., G.S.N., M.T., R.D.B., D.A.K.), the Department of Biomedical Engineering (B.T.W., J.D., E.R.M., D.A.K.), and the Department of Radiology (E.R.M.), The Johns Hopkins Medical Institutions, Baltimore, Md. , Elliot R. McVeighElliot R. McVeigh From the Division of Cardiology, the Department of Medicine (C.W.C., G.S.N., M.T., R.D.B., D.A.K.), the Department of Biomedical Engineering (B.T.W., J.D., E.R.M., D.A.K.), and the Department of Radiology (E.R.M.), The Johns Hopkins Medical Institutions, Baltimore, Md. and David A. KassDavid A. Kass From the Division of Cardiology, the Department of Medicine (C.W.C., G.S.N., M.T., R.D.B., D.A.K.), the Department of Biomedical Engineering (B.T.W., J.D., E.R.M., D.A.K.), and the Department of Radiology (E.R.M.), The Johns Hopkins Medical Institutions, Baltimore, Md. Originally published4 Jan 2000https://doi.org/10.1161/01.CIR.101.1.e2Circulation. 2000;101:e2Recent studies have generated interest in the potential for left or biventricular pacing to improve cardiac function in patients with dilated cardiomyopathy and intraventricular conduction delays.1234 The premise is that these hearts display profound basal mechanical dyssynchrony and that pacing can restore synchronization and, thereby, improve function. Here, we demonstrate the extent of mechanical dyssynchrony in such patients. Images were generated by tagged magnetic resonance imaging,567 which offers a unique noninvasive tool for determining and displaying high-resolution 3D wall motion in patients. Two images are displayed in the Figure: on the left, a normal control patient is seen, and to the right, a patient with severe cardiomyopathy and left bundle branch morphology conduction delay is shown (each image is activated by double clicking over it with the mouse). During systolic contraction, the colors change, reflecting the distribution and timing of regional circumferential strains. Red coding corresponds to the diastolic relaxed state; shortening, by a transition from red to blue; and stretch, by red to yellow. In the normal heart, contraction is synchronous within the myocardium, with a normal symmetric distribution of negative strain (≈−20% by end-systole) across the wall. In contrast, the contraction pattern is markedly dyssynchronous in the heart with dilated cardiomyopathy. Myocardium in the septal region (green dot denotes septum) becomes first blue in early systole and then yellow (ie, stretching) in late systole. Contraction slowly spreads to the lateral wall as the septum develops positive strains. The temporal magnitude of dyssynchrony is substantial. In this and other such patients, ventricular free wall (or biventricular) pacing with preexcitation1234 enhances the systolic function of the heart.The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.FootnotesCorrespondence to David A. Kass, MD, Halsted 500, the Johns Hopkins Hospital, 600 N Wolfe Street, Baltimore, MD 21287. E-mail [email protected] References 1 Blanc JJ, Etienne Y, Gilard M, Mansourati J, Munier S, Boschat J, Benditt DG, Lurie KG. Evaluation of different ventricular pacing sites in patients with severe heart failure: results of an acute hemodynamic study. 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Circulation.1999; 99:2993–3001.CrossrefMedlineGoogle Scholar5 McVeigh ER, Atalar E. Cardiac tagging with breath-hold cine MRI. Magn Reson Med.1992; 28:318–327.CrossrefMedlineGoogle Scholar6 McVeigh ER. Regional myocardial function. Cardiol Clin.1998; 16:189–206.CrossrefMedlineGoogle Scholar7 McVeigh ER, Prinzen FW, Wyman BT, Tsitlik JE, Halperin HR, Hunter WC. Imaging asynchronous mechanical activation of the paced heart with tagged MRI. Magn Reson Med.1998; 39:507–513.CrossrefMedlineGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetailsCited By Luo X, Luo P and Zhang Y (2020) Identification of differentially expressed long non-coding RNAs associated with dilated cardiomyopathy using integrated bioinformatics approaches, Drug Discoveries & Therapeutics, 10.5582/ddt.2020.01010, 14:4, (181-186), Online publication date: 31-Aug-2020. 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Mashali M, Saad N, Peczkowski K, Fanning T, Hare A, Whitson B, Mokadam N and Janssen P Mechanical Dyssynchrony of Isolated Left and Right Ventricular Human Myocardium in End-Stage Heart Failure, Circulation: Heart Failure, January 4, 2000Vol 101, Issue 1 Advertisement Article InformationMetrics Copyright © 2000 by American Heart Associationhttps://doi.org/10.1161/01.CIR.101.1.e2 Originally publishedJanuary 4, 2000 PDF download Advertisement
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