title: Global myocardial index in patients with multisite pacing.
abstract: Global myocardial index (GMI) is a sensitive echocardiographic indicator of overall cardiac function. The aim of this study was to compare the GMI changes induced by Bi-V pacing to the variations in clinical, electrocardiographic and echocardiographic parameters currently used for evaluation of ventricular resynchronization in order to test the potential marker of positive clinical response.
  
  
  METHODS
  This study included 35 consecutive patients (pts), aged 65.7+/-7.5 years, implanted with an endocavitary Bi-V pacemaker for drug refractory severe heart failure. NYHA class was evaluated before implantation and at day 30. QRS duration (QRSd), echocardiographic interventricular delay (IVD), and GMI were determined in the paced and non-paced situation at day 1, 7 and 30 after implantation.
  
  
  RESULTS
  NYHA class improved from 3.5+/-0.3 to 2.4+/-0.4 (p<0.01). GMI improved significantly (p<0.0001) after Bi-V in all pts from 1.25 +/- 0.5 to 0.77 +/- 0.34 and remained stable all along the study. GMI decrease (dGMI) in pts with NYHA functional class improvement > 0.5 was 0.52 +/- 0.16while dGMI in pts with NYHA functional class improvement < or = 0.5 was 0.21+/- 0.19. dGMI was statistically correlated with IVD shortening (r=0.67, p<0.0001) but not with QRSd shortening.
  
  
  CONCLUSIONS
  The GMI improves during Bi-V pacing, mostly in responders pts and the improvement remains unchanged after the implant. The GMI decrease induced by Bi-V pacing is correlated with the IVD shortening and NYHA functional class improvement.
authors.affiliation: Institute of Cardiovascular Medicine, Timişoara, Romania. dragoscozmafr@yahoo.fr
authors.forename: D
authors.initials: D
authors.lastname: Cozma
authors.forename: J
authors.initials: J
authors.lastname: Kalifa
authors.forename: S
authors.initials: S
authors.lastname: Pescariu
authors.forename: D
authors.initials: D
authors.lastname: Lighezan
authors.forename: J C
authors.initials: JC
authors.lastname: Deharo
authors.forename: C
authors.initials: C
authors.lastname: Mornoş
authors.forename: P
authors.initials: P
authors.lastname: Djiane
authors.forename: C T
authors.initials: CT
authors.lastname: Luca
authors.forename: L
authors.initials: L
authors.lastname: Petrescu
authors.forename: St I
authors.initials: SI
authors.lastname: Drăgulescu
mesh_terms: D000368:Aged; D002304:Cardiac Pacing, Artificial; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005602:France; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D009200:Myocardial Contraction; D012383:Romania; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome