Cardiac resynchronization improves microcirculation.
BACKGROUND
Although it is known that cardiac resynchronization therapy (CRT) in heart failure (HF) patients improves systemic circulation, its acute effects on microcirculation are as yet unknown. Therefore we investigated the sublingual microcirculatory changes in HF patients from CRT and right ventricular (RV) pacing by use of orthogonal polarization spectral (OPS) imaging.


RESULTS
Twelve consecutive HF patients with a CRT device and 20 healthy individuals (HI) were included. Acute microcirculatory changes were assessed by functional capillary density (FCD) and capillary velocity (CV) measurement 6 months after CRT. FCD and CV were measured in HF patients sublingually after 15 minutes of programming 1 of 3 pacing modalities in random order (no pacing, RV pacing, and CRT). FCD was significantly higher in HI (11.2 +/- 2.1 cm/cm(2)) compared with HF patients with RV pacing (8.9 +/- 1.9 cm/cm(2); P = .03) and no pacing (8.3 +/- 2.4 cm/cm(2); P = .02). CRT (12.1 +/- 2.2 cm/cm(2)) significantly increased FCD in HF patients compared with RV pacing (8.9 +/- 1.9 cm/cm(2); P = .006) and no pacing (8.3 +/- 2.4 cm/cm(2); P = .008). CV was normal in all patients with or without pacing.


CONCLUSIONS
CRT improves microcirculatory function as assessed by OPS imaging.
Erol-Yilmaz
Ayten
A
Department of Clinical and Experimental Cardiology, University of Amsterdam, Amsterdam, The Netherlands.
Atasever
Bektaş
B
Mathura
Keshen
K
Lindeboom
Jerome
J
Wilde
Arthur
A
Ince
Can
C
Tukkie
Raymond
R
D001783:Blood Flow Velocity / Q000502:physiology; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D012720:Severity of Illness Index; D016896:Treatment Outcome