PMID- 21421772
OWN - NLM
STAT- MEDLINE
DCOM- 20110714
LR  - 20161125
IS  - 1941-3297 (Electronic)
IS  - 1941-3289 (Linking)
VI  - 4
IP  - 3
DP  - 2011 May
TI  - Cardiac sympathetic reserve and response to cardiac resynchronization therapy.
PG  - 339-44
LID - 10.1161/CIRCHEARTFAILURE.110.959858 [doi]
AB  - BACKGROUND: The objective of the present study was to investigate the effect of 
      cardiac resynchronization therapy (CRT) on cardiac autonomic function. METHODS 
      AND RESULTS: This prospective study included 45 consecutive patients with heart 
      failure who received CRT devices with defibrillator and 20 age-matched, healthy 
      control subjects. At baseline and 3 months and 6 months after CRT, we assessed 
      New York Heart Association (NYHA) class, 6-minute walk distance, plasma 
      sympathetic biomarker nerve growth factor, echocardiography, heart rate 
      variability and cardiac presynaptic sympathetic function determined by iodine 123 
      metaiodobenzylguanidine scintigraphy. After CRT, NYHA class improved by 1 class 
      (P<0.001), and left ventricular ejection fraction increased by 8% (P<0.001). 
      Along with improvement in the standard deviation of all normal-to-normal R-R 
      intervals (85.63+/-31.66 ms versus 114.79+/-38.99 ms; P=0.004) and the standard 
      deviation of the averaged normal-to-normal R-R intervals (82.62+/-23.03 ms versus 
      100.50+/-34.87 ms; P=0.004), the delayed heart/mediastinum (H/M) ratio increased 
      (1.82 [0.58] versus 1.97 [0.59]; P=0.03), whereas the mean (SD) H/M washout rate 
      was reduced (48% [19%] versus 37% [22%]; P=0.01). Twenty-two of 45 study patients 
      responded to CRT, with a reduction of left ventricular end-systolic volume index 
      >15%. Compared with nonresponders, responders had a higher delayed H/M ratio 
      (2.11 versus 1.48; P=0.003) and lower H/M washout rate (37% versus 62%; P=0.003) 
      at baseline. CONCLUSIONS: CRT improved sympathetic function. Cardiac sympathetic 
      reserve may be a marker for the reversibility of failing myocardial function.
FAU - Cha, Yong-Mei
AU  - Cha YM
AD  - Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA. 
      ycha@mayo.edu
FAU - Chareonthaitawee, Panithaya
AU  - Chareonthaitawee P
FAU - Dong, Ying-Xue
AU  - Dong YX
FAU - Kemp, Bradley J
AU  - Kemp BJ
FAU - Oh, Jae K
AU  - Oh JK
FAU - Miyazaki, Chinami
AU  - Miyazaki C
FAU - Hayes, David L
AU  - Hayes DL
FAU - Rea, Robert F
AU  - Rea RF
FAU - Asirvatham, Samuel J
AU  - Asirvatham SJ
FAU - Webster, Tracy L
AU  - Webster TL
FAU - Dalzell, Connie M
AU  - Dalzell CM
FAU - Hodge, David O
AU  - Hodge DO
FAU - Herges, Regina M
AU  - Herges RM
FAU - Yong, Yan-Zhong
AU  - Yong YZ
FAU - Zhang, Yanhua
AU  - Zhang Y
FAU - Chen, Peng-Sheng
AU  - Chen PS
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110318
PL  - United States
TA  - Circ Heart Fail
JT  - Circulation. Heart failure
JID - 101479941
RN  - 9061-61-4 (Nerve Growth Factor)
SB  - IM
MH  - Aged
MH  - *Cardiac Resynchronization Therapy
MH  - Female
MH  - Heart/*innervation
MH  - Heart Failure/blood/diagnostic imaging/physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nerve Growth Factor/blood
MH  - Radionuclide Imaging
MH  - Sympathetic Nervous System/*physiopathology
EDAT- 2011/03/23 06:00
MHDA- 2011/07/16 06:00
CRDT- 2011/03/23 06:00
PHST- 2011/03/23 06:00 [entrez]
PHST- 2011/03/23 06:00 [pubmed]
PHST- 2011/07/16 06:00 [medline]
AID - CIRCHEARTFAILURE.110.959858 [pii]
AID - 10.1161/CIRCHEARTFAILURE.110.959858 [doi]
PST - ppublish
SO  - Circ Heart Fail. 2011 May;4(3):339-44. doi: 10.1161/CIRCHEARTFAILURE.110.959858. 
      Epub 2011 Mar 18.