Pacing tachycardia exaggerates left ventricular diastolic dysfunction but not systolic function and regional asynergy or asynchrony in patients with hypertrophic cardiomyopathy
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
Toshiaki TarumiTetsu Yamakado
Abstract
Myocardial ischaemia and angina have been demonstrated in patients with hypertrophic cardiomyopathy (HCM). We hypothesized that left ventricular (LV) systolic or diastolic dysfunction would be provocated by pacing tachycardia in patients with HCM. We investigated LV global and regional systolic and diastolic function in 17 patients with HCM without LV outflow obstruction and 7 normal subjects by analysing LV angiograms and simultaneously obtained high-fidelity LV pressures before and after rapid cardiac pacing (150 b.p.m.). Biplane LV silhouettes were digitized frame by frame (50 frames/s). To quantify regional dynamics, the ventricular area of the right anterior oblique projection was divided into six sections originating from the midpoint of the long axis at end-diastole. There were no significant changes in LV function after pacing in normal subjects. In HCM, the ejection fractions remained unchanged. However, LV end-diastolic pressures rose (+12 mmHg, P < 0.01), and the time constants of isovolumic pressure decay were significantly increased (T(1/2): +5.2 ms, P < 0.01; T(1/)(e): +6.8 ms, P < 0.01). The LV global diastolic pressure-volume relationships and regional diastolic pressure-area relationships of regional myocardium...Continue Reading
References
Jun 1, 1992·Circulation·E J EichhornP A Grayburn
Mar 11, 1991·The Journal of Clinical Investigation·J K GwathmeyJ P Morgan
Mar 15, 1991·Journal of the American College of Cardiology·P CamiciL Papi
Feb 1, 1990·Circulation Research·L HittingerS F Vatner
Mar 1, 1990·Circulation·W J PaulusE Andries
Dec 1, 1989·Circulation Research·K NakanoB A Carabello
Feb 1, 1989·Circulation·J E UdelsonR O Bonow
Oct 1, 1989·Physiological Reviews·D L Brutsaert, S U Sys
Mar 1, 1988·Circulation Research·A M FujiiS F Vatner
Dec 1, 1987·Circulation·M R StarlingR A Walsh
Oct 1, 1986·Circulation·M A FiferB H Lorell
May 1, 1985·Circulation·J M AroestyW Grossman
Feb 1, 1985·Circulation·R O CannonS E Epstein
Apr 1, 1984·Circulation·I Mirsky
Feb 1, 1983·Circulation·P D BourdillonW Grossman
Jul 1, 1983·Circulation·J D CarrollH P Krayenbuehl
May 1, 1981·Circulation·M FujitaM Kuwahara
Nov 1, 1993·Circulation·S BetocchiH P Krayenbuehl
Aug 1, 1993·Circulation·B De BruyneW J Paulus
Jul 1, 1996·European Heart Journal·P M ElliottW J McKenna
Mar 21, 1998·European Heart Journal·U LimbrunoM Mariani
May 15, 1998·Journal of the American College of Cardiology·H L ThomsonM Frenneaux
Sep 12, 2003·The New England Journal of Medicine·Franco CecchiPaolo G Camici
Aug 22, 2009·Journal of the American College of Cardiology·Martin S MaronPaolo G Camici
Oct 24, 2009·Circulation. Heart Failure·Ronen RubinshteinBernard J Gersh