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Effects of cardiac resynchronization therapy on coronary blood flow: Evaluation by transthoracic Doppler echocardiography
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2008 (English)In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 10, no 5, 514-520 p.Article in journal (Refereed) Published
Abstract [en]

Background: Relatively limited and conflicting data are available on the effects of cardiac resynchronization therapy (CRT) on coronary blood flow (CBF). Aims: To investigate changes in the left anterior descending coronary artery (LAD) flow under different CRT pacing modes by means of transthoracic Doppler echocardiography (TTE). Methods: Twenty-two responders to CRT (67 11 years) with idiopathic dilated cardiomyopathy underwent TTE assessment of LAD flow and Tissue Velocity Imaging during 4 programming modes: intrinsic conduction (IC), right ventricular pacing (RV), simultaneous biventricular pacing (BVP), BVP with left ventricular (LV) pre-activation. Results: Mean coronary flow velocity (CFV) was increased by simultaneous BVP (p = 0.0063 vs. IC) and BVP with LV pre-activation (p<0.0001 vs. IC; p=0.027 vs. simultaneous BVP). Peak CFV and LAD flow velocity/time integral were highest during BVP with LV pre-activation. A reduction in septal-to-lateral delay and an increase in peak systolic velocity in the basal septum were observed during simultaneous BVP and BVP with LV pre-activation. Conclusions: In CRT responders with idiopathic dilated cardiomyopathy, an increase in LAD flow, assessed by TTE, was observed during simultaneous BVP and BVP with LV pre-activation. This was associated with an improvement in regional myocardial contraction and a decrease in intraventricular dyssynchrony.

Place, publisher, year, edition, pages
2008. Vol. 10, no 5, 514-520 p.
Keyword [en]
cardiac resynchronization therapy, echocardiography, coronary blood flow, bundle-branch block, positron-emission-tomography, left-ventricular, dyssynchrony, heart-failure, dilated cardiomyopathy, myocardial-perfusion, oxygen-consumption, noninvasive assessment, reserve, metabolism
URN: urn:nbn:se:kth:diva-17600DOI: 10.1016/j.ejheart.2008.03.011ISI: 000256673200012ScopusID: 2-s2.0-42749093962OAI: diva2:335644
QC 20100525Available from: 2010-08-05 Created: 2010-08-05 Last updated: 2010-10-04Bibliographically approved

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Brodin, Lars-Åke
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