PMID- 16253911
OWN - NLM
STAT- MEDLINE
DCOM- 20060117
LR  - 20161222
IS  - 1547-5271 (Print)
IS  - 1547-5271 (Linking)
VI  - 2
IP  - 11
DP  - 2005 Nov
TI  - Extent of myocardial viability predicts response to biventricular pacing in 
      ischemic cardiomyopathy.
PG  - 1211-7
AB  - BACKGROUND: The clinical response to biventricular pacing is unpredictable, 
      especially in patients with ischemic cardiomyopathy. OBJECTIVES: The purpose of 
      this study was to prospectively examine the relationship between the extent of 
      myocardial viability and the response to cardiac resynchronization therapy. 
      METHODS: Twenty-one patients with ischemic left ventricular (LV) dysfunction 
      (left ventricular ejection fraction [LVEF] 21 +/- 5%), New York Heart Association 
      (NYHA) functional class III-IV, and QRS >120 ms received biventricular devices. 
      Myocardial viability was assessed by myocardial contrast echocardiography, and a 
      perfusion score index (PSI) was calculated from summed segmental perfusion 
      scores. LV performance was assessed by echocardiography on the day after 
      implantation and at 6 months. RESULTS: PSI was closely correlated with acute 
      improvement in LVEF (P = .003, r = 0.65), stroke volume (P = .02, r = 0.54), and 
      end-systolic volume (P = .05, r = -0.49). PSI also correlated with early 
      diastolic LV relaxation (E', P < .05, r = 0.50) and global myocardial performance 
      or Tei index (P = .003, r = 0.63). By multiple linear regression analysis, PSI 
      provided incremental predictive value to the degree of dyssynchrony, measured by 
      tissue Doppler imaging, for predicting improvement in LVEF. At 6 months, PSI 
      remained positively correlated with improvement in ventricular performance and 
      with reduction in LV end-diastolic dimension (P = .003, r = -0.68). PSI also 
      influenced the clinical variables of NYHA class, 6-minute walk distance, 
      quality-of-life score, and number of hospitalizations for heart failure. 
      CONCLUSION: In patients with ischemic cardiomyopathy, the extent of myocardial 
      viability predicts acute and long-term improvement in LV performance, exercise 
      tolerance, and reduction in LV end-diastolic dimension with biventricular pacing.
FAU - Hummel, James P
AU  - Hummel JP
AD  - Cardiovascular Division, University of Virginia School of Medicine, 
      Charlottesville, VA 22908, USA. jph4b@virginia.edu
FAU - Lindner, Jonathan R
AU  - Lindner JR
FAU - Belcik, J Todd
AU  - Belcik JT
FAU - Ferguson, John D
AU  - Ferguson JD
FAU - Mangrum, J Michael
AU  - Mangrum JM
FAU - Bergin, James D
AU  - Bergin JD
FAU - Haines, David E
AU  - Haines DE
FAU - Lake, Douglas E
AU  - Lake DE
FAU - DiMarco, John P
AU  - DiMarco JP
FAU - Mounsey, J Paul
AU  - Mounsey JP
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Heart Rhythm
JT  - Heart rhythm
JID - 101200317
SB  - IM
MH  - Aged
MH  - Cardiac Pacing, Artificial/*methods
MH  - Echocardiography, Doppler
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Ventricles/diagnostic imaging/*physiopathology
MH  - Humans
MH  - Male
MH  - Myocardial Contraction/physiology
MH  - Myocardial Ischemia/diagnostic imaging/*physiopathology/therapy
MH  - Prognosis
MH  - Prospective Studies
MH  - Stroke Volume/physiology
MH  - Tissue Survival/*physiology
MH  - Ventricular Function, Left/*physiology
MH  - Ventricular Remodeling/*physiology
EDAT- 2005/10/29 09:00
MHDA- 2006/01/18 09:00
CRDT- 2005/10/29 09:00
PHST- 2005/01/05 00:00 [received]
PHST- 2005/07/27 00:00 [accepted]
PHST- 2005/10/29 09:00 [pubmed]
PHST- 2006/01/18 09:00 [medline]
PHST- 2005/10/29 09:00 [entrez]
AID - S1547-5271(05)01892-8 [pii]
AID - 10.1016/j.hrthm.2005.07.027 [doi]
PST - ppublish
SO  - Heart Rhythm. 2005 Nov;2(11):1211-7. doi: 10.1016/j.hrthm.2005.07.027.