PMID- 16844919
OWN - NLM
STAT- MEDLINE
DCOM- 20070116
LR  - 20200930
IS  - 0363-6135 (Print)
IS  - 0363-6135 (Linking)
VI  - 291
IP  - 6
DP  - 2006 Dec
TI  - Sympathetic control after cardiac resynchronization therapy: responders versus 
      nonresponders.
PG  - H2647-52
AB  - Cardiac resynchronization therapy (CRT) decreases muscle sympathetic nerve 
      activity (MSNA) in patients with severe congestive heart failure (CHF) and 
      cardiac asynchrony. Whether this affects equally patients who clinically respond 
      or not to CRT is unknown. We tested the hypothesis that the favorable effects of 
      CRT on MSNA disappear on CRT interruption only in those who respond to CRT. 
      Twenty-three consecutive CHF patients participated in the study, among whom 16 
      presented a symptomatic improvement by one or more New York Heart Association 
      (NYHA) functional classes 15 +/- 5 mo after CRT (responders), and seven had not 
      improved after 12 +/- 4 mo of CRT (nonresponders). MSNA and echocardiographic 
      recordings were obtained in random order during atrio-right ventricular pacing 
      (ARV), without stimulation in patients who were not pacemaker dependent (OFF, n = 
      17), and during atrio-biventricular pacing (BIV). Responders had a longer 6-min 
      walking distance, a lower NYHA class and brain natriuretic peptide levels, and a 
      better quality of life than did nonresponders (all P < 0.05). MSNA increased by 
      25 +/- 7% in the responders, whereas it remained unchanged in the nonresponders, 
      when shifting from the BIV mode to a nonsynchronous condition (ARV and OFF modes) 
      (P < 0.01). Cardiac output decreased by 0.7 +/- 0.2 l/min in the responders but 
      did not change when shifting from the BIV mode to the nonsynchronous pacing mode 
      in the nonresponders (P < 0.01). In conclusion, reversible sympathoinhibition is 
      a marker of the clinical response to CRT.
FAU - Najem, Boutaina
AU  - Najem B
AD  - Dept. of Cardiology, Erasme Hospital, 1070 Brussels, Belgium. bnajem@ulb.ac.be
FAU - Unger, Philippe
AU  - Unger P
FAU - Preumont, Nicolas
AU  - Preumont N
FAU - Jansens, Jean-Luc
AU  - Jansens JL
FAU - Houssiere, Anne
AU  - Houssiere A
FAU - Pathak, Atul
AU  - Pathak A
FAU - Xhaet, Olivier
AU  - Xhaet O
FAU - Gabriel, Laurence
AU  - Gabriel L
FAU - Friart, Alain
AU  - Friart A
FAU - De Roy, Luc
AU  - De Roy L
FAU - Vandenbossche, Jean-Luc
AU  - Vandenbossche JL
FAU - van de Borne, Philippe
AU  - van de Borne P
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20060714
PL  - United States
TA  - Am J Physiol Heart Circ Physiol
JT  - American journal of physiology. Heart and circulatory physiology
JID - 100901228
RN  - 0 (Receptors, Adrenergic)
SB  - IM
CIN - Am J Physiol Heart Circ Physiol. 2006 Dec;291(6):H2590-1. PMID: 16877559
MH  - Aged
MH  - Bundle-Branch Block/*physiopathology
MH  - Cardiac Output
MH  - Cardiac Output, Low/physiopathology/*therapy
MH  - *Cardiac Pacing, Artificial
MH  - Electrocardiography
MH  - Female
MH  - Heart Conduction System/*physiopathology
MH  - Heart Ventricles/innervation/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Contraction/physiology
MH  - Receptors, Adrenergic/*physiology
MH  - Retrospective Studies
MH  - Sympathetic Nervous System/*physiology
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/physiopathology
EDAT- 2006/07/18 09:00
MHDA- 2007/01/17 09:00
CRDT- 2006/07/18 09:00
PHST- 2006/07/18 09:00 [pubmed]
PHST- 2007/01/17 09:00 [medline]
PHST- 2006/07/18 09:00 [entrez]
AID - 00373.2006 [pii]
AID - 10.1152/ajpheart.00373.2006 [doi]
PST - ppublish
SO  - Am J Physiol Heart Circ Physiol. 2006 Dec;291(6):H2647-52. doi: 
      10.1152/ajpheart.00373.2006. Epub 2006 Jul 14.