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Improvement of left ventricular wall synchronization with multisite ventricular pacing in heart failure: a prospective study using Doppler tissue imaging
Author(s) -
Lafitte Stephane,
Garrigue Stephane,
Perron JeanMarie,
Bordachar Pierre,
Reuter Sylvain,
Jaïs Pierre,
Haïssaguerre Michel,
Clementy Jacques,
Roudaut Raymond
Publication year - 2004
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2003.10.008
Subject(s) - medicine , cardiology , ventricular pacing , heart failure , ejection fraction , qrs complex , doppler imaging , dilated cardiomyopathy , regurgitation (circulation) , diastole , blood pressure
We sought to assess right, left and biventricular pacing effects on myocardial function by using pulsed‐Doppler tissue imaging (DTI) and automated border detection (ABD) techniques which provide electromechanical delay (EMD) assessment of the different left ventricular walls. Methods: 15 patients (67±7 years) with drug‐resistant primitive dilated cardiomyopathy and QRS≥140 ms received a pacemaker for multisite ventricular pacing. Echocardiography was performed after 1 month of biventricular pacing (BVP). Echocardiographic measurements were recorded during spontaneous rhythm (SpR), right ventricular pacing (RVP), left ventricular pacing (LVP) and BVP. Results: LV ejection fraction was statistically similar between the four rhythms. BVP showed a significant EMD decrease for the lateral LV wall vs. SpR, RVP and even LVP. LVP resulted in significantly longer aortic pre‐ejection time vs. BVP while the EMD temporal dispersion (time between the shortest regional EMD and the longest one) was similar in the two modes. Conclusions: BVP and LVP substantially reduce the EMD temporal dispersion of the four LV walls, but with a longer aortic pre‐ejection time for LVP. In RVP, LVP and BVP, the septal LV wall is always activated later than during SpR. BVP and LVP are associated with a mitral regurgitation reduction.