Global and regional wall motion abnormalities of pacing-induced heart failure assessed by multi-detector row CT: a patient and canine model study.
This study used multi-detector row CT (MDCT) to evaluate the regional geometric parameters of left ventricle (LV) in patients and dogs after right ventricular apical (RVA) pacing. First, we measured and compared the global and regional wall motion parameters derived from MDCT images between three patients post RVA pacing and seven age-matched healthy subjects. The LV ejection fraction (LVEF), LV end-diastolic volume and LV end-systolic volume were measured. We also measured the regional wall thickness, wall thickening and regional wall motion in 12 different segments of the LV. Second, we performed MDCT scan on five dogs as the study group (pacing wire + RVA pacing, 2 months) and four dogs as the sham control group (pacing wire, 2 months). The global and regional geometric parameters were compared within both human and canine groups. Compared with normal subjects, patients post RVA pacing had low LVEF (60.4 ± 10.5 vs. 33.2 ± 17.6, P = 0.014), impaired regional wall thickening and regional wall motion, particularly in segments near the pacing lead. Some segments near the pacing lead were showing dyskinesia after pacing. These findings were successfully reproduced in the canine model. We found that RVA pacing can result in impaired regional wall thickening and regional wall motion, particularly in segments near the pacing lead.
Tsai
I-Chen
IC
Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan.
Huang
Jin-Long
JL
Ueng
Kwo-Chang
KC
Hung
Yi-Wen
YW
Hung
Chin-Fang
CF
Liao
Wan-Chun
WC
Lei
Ho-Yi
HY
Chen
Min-Chi
MC
Tsai
Wei-Lin
WL
Chen
Shih-Ann
SA
Chen
Clayton Chi-Chang
CC
Fu
Yun-Ching
YC
Ting
Chih-Tai
CT
D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002304:Cardiac Pacing, Artificial; D016022:Case-Control Studies; D004195:Disease Models, Animal; D004285:Dogs; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D009200:Myocardial Contraction; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013318:Stroke Volume; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D016277:Ventricular Function, Left