Mechanical alternans in patients with chronic heart failure

Journal of Cardiac Failure
Makoto KodamaY Aizawa

Abstract

Clinical implications of mechanical alternans in patients with chronic heart failure have remained uncertain. In this study, prevalence, characteristics, and prognostic implications of mechanical alternans were investigated. Consecutive 51 patients with dilated cardiomyopathy underwent diagnostic cardiac catheterization using a micromanometer-tipped catheter. Under basal conditions, 7 of 35 patients with sinus rhythm showed mechanical alternans. Physiologic tachycardia (110 bpm) induced mechanical alternans in another 15 patients with sinus rhythm and in another 10 of 16 patients with atrial fibrillation. Low doses of dobutamine also induced mechanical alternans in another 8 patients, but a high dose of dobutamine eliminated mechanical alternans. Consequently, 40 patients (78%) showed mechanical alternans. Mechanical alternans was always accompanied by alternating changes of positive dP/dt, a parameter of contractility during isovolumetric contraction time, but negative dP/dt was occasionally constant. Concordant mechanical alternans between both ventricles was more prevalent than discordant alternans. The left ventricular end-diastolic volume indices and end-systolic volume indices of patients with mechanical alternans were la...Continue Reading

Citations

Aug 8, 2012·Cardiovascular Research·Michael J BroundJames D Johnson
Nov 28, 2015·Basic Research in Cardiology·Cristina E MolinaLeif Hove-Madsen
Jan 13, 2006·Pacing and Clinical Electrophysiology : PACE·Makoto KodamaYoshifusa Aizawa
Nov 16, 2014·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Wei HuaShu Zhang
Dec 2, 2004·Experimental Physiology·David A EisnerA W Trafford
Apr 4, 2006·Journal of the American College of Cardiology·Akihiro HirashikiMitsuhiro Yokota
Mar 4, 2014·Circulation. Arrhythmia and Electrophysiology·Robert KimLarisa G Tereshchenko
Jan 31, 2004·Circulation Research·Mary E DíazDavid A Eisner
Mar 20, 2004·Journal of Cardiovascular Electrophysiology·Makoto KodamaYoshifusa Aizawa
Jun 2, 2011·Internal Medicine·Masahiro ItoYoshifusa Aizawa
Sep 13, 2013·Pacing and Clinical Electrophysiology : PACE·Takeshi KashimuraTohru Minamino
Jul 16, 2010·Clinical and Experimental Pharmacology & Physiology·Akihiro HirashikiToyoaki Murohara

Related Concepts

Cardiac Arrhythmia
Myocardial Failure
Hemodynamics
Myocardial Contraction
Left Ventricular Function

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