PMID- 21794181
OWN - NLM
STAT- MEDLINE
DCOM- 20111220
LR  - 20211020
IS  - 1476-7120 (Electronic)
IS  - 1476-7120 (Linking)
VI  - 9
DP  - 2011 Jul 28
TI  - Pre-ejection period by radial artery tonometry supplements echo Doppler findings 
      during biventricular pacemaker optimization.
PG  - 20
LID - 10.1186/1476-7120-9-20 [doi]
AB  - BACKGROUND: Biventricular (Biv) pacemaker echo optimization has been shown to 
      improve cardiac output however is not routinely used due to its complexity. We 
      investigated the role of a simple method involving computerized pre-ejection time 
      (PEP) assessment by radial artery tonometry in guiding Biv pacemaker 
      optimization. METHODS: Blinded echo and radial artery tonometry were performed 
      simultaneously in 37 patients, age 69.1 +/- 12.8 years, left ventricular (LV) 
      ejection fraction (EF) 33 +/- 10%, during Biv pacemaker optimization. Effect of 
      optimization on echo derived velocity time integral (VTI), ejection time (ET), 
      myocardial performance index (MPI), radial artery tonometry derived PEP and 
      echo-radial artery tonometry derived PEP/VTI and PEP/ET indices was evaluated. 
      RESULTS: Significant improvement post optimization was achieved in LV ET (286.9 +/- 
      37.3 to 299 +/- 34.6 ms, p < 0.001), LV VTI (15.9 +/- 4.8 cm to 18.4 +/- 5.1 cm, p < 
      0.001) and MPI (0.57 +/- 0.2 to 0.45 +/- 0.13, p < 0.001) and in PEP (246.7 +/- 36.1 ms 
      to 234.7 +/- 35.5 ms, p = 0.003), PEP/ET (0.88 +/- 0.21 to 0.79 +/- 0.17, p < 0.001), 
      and PEP/VTI (17.3 +/- 7 to 13.78 +/- 4.7, p < 0.001). The correlation between 
      comprehensive echo Doppler and radial artery tonometry-PEP guided optimal 
      atrioventricular delay (AVD) and optimal interventricular delay (VVD) was 0.75 (p 
      < 0.001) and 0.69 (p < 0.001) respectively. In 29 patients with follow up 
      assessment, New York Heart Association (NYHA) class reduced from 2.5 +/- 0.8 to 2.0 
      +/- 0.9 (p = 0.004) at 1.8 +/- 1.4 months. CONCLUSION: An acute shortening of PEP by 
      radial artery tonometry occurs post Biv pacemaker optimization and correlates 
      with improvement in hemodynamics by echo Doppler and may provide a cost-efficient 
      approach to assist with Biv pacemaker echo optimization.
FAU - Taha, Nima
AU  - Taha N
AD  - Non Invasive Diagnostic Services and Echocardiography Laboratory, Cardiovascular 
      and Thoracic Institute, Keck School of Medicine, University of Southern 
      California, Los Angeles, USA.
FAU - Zhang, Jing
AU  - Zhang J
FAU - Rafie, Reza
AU  - Rafie R
FAU - Ranjan, Rupesh
AU  - Ranjan R
FAU - Qamruddin, Salima
AU  - Qamruddin S
FAU - Naqvi, Tasneem Z
AU  - Naqvi TZ
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110728
PL  - England
TA  - Cardiovasc Ultrasound
JT  - Cardiovascular ultrasound
JID - 101159952
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiac Pacing, Artificial/*methods/standards
MH  - Echocardiography, Doppler/*methods
MH  - Female
MH  - Heart Failure/diagnostic imaging/*therapy
MH  - Hemodynamics/physiology
MH  - Humans
MH  - Male
MH  - Manometry/*methods
MH  - Middle Aged
MH  - Myocardial Contraction/physiology
MH  - Pulsatile Flow/physiology
MH  - Radial Artery/*physiology
MH  - Stroke Volume/*physiology
MH  - Treatment Outcome
MH  - Ultrasonography, Interventional/methods
PMC - PMC3162875
EDAT- 2011/07/29 06:00
MHDA- 2011/12/21 06:00
PMCR- 2011/07/28
CRDT- 2011/07/29 06:00
PHST- 2011/06/05 00:00 [received]
PHST- 2011/07/28 00:00 [accepted]
PHST- 2011/07/29 06:00 [entrez]
PHST- 2011/07/29 06:00 [pubmed]
PHST- 2011/12/21 06:00 [medline]
PHST- 2011/07/28 00:00 [pmc-release]
AID - 1476-7120-9-20 [pii]
AID - 10.1186/1476-7120-9-20 [doi]
PST - epublish
SO  - Cardiovasc Ultrasound. 2011 Jul 28;9:20. doi: 10.1186/1476-7120-9-20.