PMID- 17868811
OWN - NLM
STAT- MEDLINE
DCOM- 20071018
LR  - 20070917
IS  - 1558-3597 (Electronic)
IS  - 0735-1097 (Linking)
VI  - 50
IP  - 12
DP  - 2007 Sep 18
TI  - Speckle-tracking radial strain reveals left ventricular dyssynchrony in patients 
      with permanent right ventricular pacing.
PG  - 1180-8
AB  - OBJECTIVES: Speckle-tracking strain analysis was used to assess the effects of 
      permanent right ventricular (RV) pacing on the heterogeneity in timing of 
      regional wall strain and left ventricular (LV) dyssynchrony. BACKGROUND: Recent 
      studies have shown detrimental effects of RV pacing, possibly related to the 
      induction of LV dyssynchrony. METHODS: Fifty-eight patients treated with His 
      bundle ablation and pacemaker implantation were studied. To assess the effect of 
      RV pacing on time-to-peak radial strain of different LV segments, we applied 
      speckle-tracking analysis to standard LV short-axis images. In addition, New York 
      Heart Association (NYHA) functional class, LV volumes, and systolic function were 
      assessed at baseline and after long-term RV pacing. RESULTS: At baseline, similar 
      time-to-peak strain for the 6 segments was observed (mean 371 +/- 114 ms). In 
      contrast, after a mean of 3.8 +/- 2.0 years of RV pacing, there was a marked 
      heterogeneity in time-to-peak strain of the 6 segments. In 33 patients (57%), LV 
      dyssynchrony, represented by a time difference > or =130 ms between the 
      time-to-peak strain of the (antero)septal and the posterolateral segments, was 
      present. In these patients, a deterioration of LV systolic function and NYHA 
      functional class was observed. In 11 patients, an "upgrade" of the conventional 
      pacemaker to a biventricular pacemaker resulted in partial reversal of the 
      detrimental effects of RV pacing. CONCLUSIONS: Speckle-tracking analysis revealed 
      that permanent RV pacing induced heterogeneity in time-to-peak strain, resulting 
      in LV dyssynchrony in 57% of patients, associated with deterioration of LV 
      systolic function and NYHA functional class. Biventricular pacing may reverse 
      these adverse effects of RV pacing.
FAU - Tops, Laurens F
AU  - Tops LF
AD  - Department of Cardiology, Leiden University Medical Center, Leiden, The 
      Netherlands. l.f.tops@lumc.nl
FAU - Suffoletto, Matthew S
AU  - Suffoletto MS
FAU - Bleeker, Gabe B
AU  - Bleeker GB
FAU - Boersma, Eric
AU  - Boersma E
FAU - van der Wall, Ernst E
AU  - van der Wall EE
FAU - Gorcsan, John 3rd
AU  - Gorcsan J 3rd
FAU - Schalij, Martin J
AU  - Schalij MJ
FAU - Bax, Jeroen J
AU  - Bax JJ
LA  - eng
PT  - Journal Article
DEP - 20070904
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
MH  - Aged
MH  - Analysis of Variance
MH  - Atrial Fibrillation/diagnosis/*therapy
MH  - Atrioventricular Node/*surgery
MH  - Cardiac Pacing, Artificial/methods
MH  - Catheter Ablation/methods
MH  - Combined Modality Therapy
MH  - Echocardiography/methods
MH  - Electrophysiologic Techniques, Cardiac/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Monitoring, Physiologic/methods
MH  - Sensitivity and Specificity
MH  - Stroke Volume
MH  - Ventricular Dysfunction, Left/*diagnosis
MH  - Ventricular Dysfunction, Right/*diagnosis
EDAT- 2007/09/18 09:00
MHDA- 2007/10/19 09:00
CRDT- 2007/09/18 09:00
PHST- 2007/01/08 00:00 [received]
PHST- 2007/06/14 00:00 [revised]
PHST- 2007/06/21 00:00 [accepted]
PHST- 2007/09/18 09:00 [pubmed]
PHST- 2007/10/19 09:00 [medline]
PHST- 2007/09/18 09:00 [entrez]
AID - S0735-1097(07)02046-3 [pii]
AID - 10.1016/j.jacc.2007.06.011 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2007 Sep 18;50(12):1180-8. doi: 10.1016/j.jacc.2007.06.011. 
      Epub 2007 Sep 4.