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Physiological relevance of quantifying segmental contraction synchrony

Johnson, L and Lamia, B and Kim, HK and Tanabe, M and Gorcsan, J and Schwartzman, D and Shroff, SG and Pinsky, MR (2012) Physiological relevance of quantifying segmental contraction synchrony. PACE - Pacing and Clinical Electrophysiology, 35 (2). 174 - 187. ISSN 0147-8389

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Abstract

Background: Most current indices of synchrony quantify left ventricular (LV) contraction pattern in terms of a single, global (integrated) measure. We report the development and physiological relevance of a novel method to quantify LV segmental contraction synchrony. Methods: LV pressure-volume and echocardiographic data were collected in seven anesthetized, opened-chest dogs under several pacing modes: right atrial (RA) (control), right ventricular (RV) (dyssynchrony), and additional LV pacing at either apex (CRTa) or free wall (CRTf). Cross-correlation-based integrated (CCSI ) and segmental (CCSI ) measures of synchrony were calculated from speckle-tracking derived radial strain, along with a commonly used index (maximum time delay). LV contractility was quantified using either E (ESPVR slope) or ESPVR (defined in the manuscript). Results: RV pacing decreased CCSI at LV base (0.95 ± 0.02 [RA] vs 0.64 ± 0.14 [RV]; P < 0.05) and only CRTa improved it (0.93 ± 0.03; P < 0.05 vs RV). The CCSI analysis identified anteroseptal and septal segments as being responsible for the low CCSI during RV pacing and inferior segment for poor resynchronization with CRTf. Changes in ESPVR , and not in E , indicated depressed LV contractility with RV pacing, an observation consistent with significantly decreased global LV performance (stroke work [SW]: 252 ± 23 [RA] vs 151 ± 24 [RV] mJ; P < 0.05). Only CRTa improved SW and contractility (SW: 240 ± 19 mJ; ESPVR : 545 ± 175 mmHg•mL; both P < 0.01 vs RV). Only changes in CCSI and global LV contractility were strongly correlated (R = 0.698, P = 0.005). Conclusion: CCSI provided insights into the changes in LV integrated contraction pattern and a better link to global LV contractility changes. © 2012 Wiley Periodicals, Inc. int seg es area int seg int area es area seg seg 2


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Johnson, L
Lamia, B
Kim, HKhyk11@pitt.eduHYK11
Tanabe, M
Gorcsan, Jgorcsan@pitt.eduGORCSAN
Schwartzman, D
Shroff, SGsshroff@pitt.eduSSHROFF
Pinsky, MRpinsky@pitt.eduPINSKY0000-0001-6166-700X
Date: 1 February 2012
Date Type: Publication
Journal or Publication Title: PACE - Pacing and Clinical Electrophysiology
Volume: 35
Number: 2
Page Range: 174 - 187
DOI or Unique Handle: 10.1111/j.1540-8159.2011.03246.x
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 0147-8389
PubMed ID: 22017611
Date Deposited: 07 Mar 2012 20:57
Last Modified: 30 Mar 2021 14:56
URI: http://d-scholarship.pitt.edu/id/eprint/11378

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