Effect of cardiac resynchronization therapy on global and regional oxygen consumption and myocardial blood flow in patients with non-ischaemic and ischaemic cardiomyopathy.
OBJECTIVE
We studied the effects of cardiac resynchronization therapy (CRT) on global and regional myocardial oxygen consumption (MVO2) and myocardial blood flow (MBF) in non-ischaemic (NICM) and ischaemic dilated cardiomyopathy (ICM).


RESULTS
Thirty-one NICM and 11 ICM patients, all of them acute responders, were investigated. MVO2 and MBF were obtained by 11C-acetate PET before and after 4 months of CRT. In NICM global MVO2 and MBF did not change during CRT, while the rate pressure product (RPP) normalized MVO2 increased (P=0.03). Before CRT regional MVO2 and MBF were highest in the lateral wall and lowest in the septum. Under therapy, MVO2 and MBF decreased in the lateral wall (P=0.045) and increased in the septum (P=0.045) resulting in a more uniform distribution. In ICM, global MVO2, MBF, and RPP did not change under CRT. Regional MVO2 and MBF showed no significant changes but a similar tendency in the lateral and septal wall to that in NICM.


CONCLUSIONS
CRT induces changes of MVO2 and MBF on a regional level with a more uniform distribution between the myocardial walls and improved ventricular efficiency in NICM. Based on the investigated parameters, CRT appears to be more effective in NICM than in ICM.
Lindner
Oliver
O
Institute of Molecular Biophysics, Radiopharmacy, and Nuclear Medicine, Heart and Diabetes Center North Rhine-Westphalia, Georgstr. 11, D-32545 Bad Oeynhausen, Germany. olindner@hdz-nrw.de
Vogt
Jürgen
J
Kammeier
Annett
A
Wielepp
Peter
P
Holzinger
Jens
J
Baller
Detlev
D
Lamp
Barbara
B
Hansky
Bert
B
Körfer
Reiner
R
Horstkotte
Dieter
D
Burchert
Wolfgang
W
D000704:Analysis of Variance; D001794:Blood Pressure / Q000502:physiology; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D002311:Cardiomyopathy, Dilated / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D003326:Coronary Circulation / Q000502:physiology*; D006801:Humans; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D010101:Oxygen Consumption / Q000502:physiology*; D049268:Positron-Emission Tomography