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Cardiac resynchronization therapy cures dyssynchronopathy in canine left bundle-branch block hearts

2007; Oxford University Press; Volume: 28; Issue: 17 Linguagem: Inglês

10.1093/eurheartj/ehm207

1522-9645

Kevin Vernooy, Richard Cornelussen, Xander Verbeek, Ward Y. Vanagt, Arne van Hunnik, Marion Kuiper, Theo Arts, Harry J.G.M. Crijns, Frits W. Prinzen,

Cardiomyopathy and Myosin Studies

We investigated to what extent biventricular pacing (BVP) can normalize LV function and remodeling, induced by isolated left bundle branch block (LBBB).In 16 dogs LBBB was induced. Eight animals were followed for 16 weeks and in 8 animals BVP was started after 8 weeks. LV pressure, LV geometry (2Dechocardiography), systolic circumferential shortening (CSsys, MRI tagging) and myocardial blood flow (MBF, microspheres) was measured. * and # indicate P < 0.05 compared to pre-LBBB and 8 weeks of LBBB, respectively. Data is presented relative to pre-LBBB values (mean +/- SEM). BVP increased LV dP/dt|max from 78 +/- 5%* to 86 +/- 5%*# (immediately) and 89 +/- 6%# (after 8 weeks) and normalized regional differences in CSsys and MBF. After 8 weeks of BVP, LV end-diastolic volume (EDV) was reduced from 123 +/- 3%* to 109 +/- 6%# and LV lateral wall mass was reduced from 128 +/- 5%* to 113 +/- 3%*#. The acute increase in LV dP/dt|max upon BVP correlated with LV EDV and LV wall mass after 8 weeks of BVP.In canine hearts with long-term isolated LBBB, BVP largely reverses global and regional functional and structural abnormalities induced by LBBB.