title: Global and regional wall motion abnormalities of pacing-induced heart failure assessed by multi-detector row CT: a patient and canine model study.
abstract: 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.
authors: Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors: I-Chen
authors: IC
authors: Tsai
authors: Jin-Long
authors: JL
authors: Huang
authors: Kwo-Chang
authors: KC
authors: Ueng
authors: Yi-Wen
authors: YW
authors: Hung
authors: Chin-Fang
authors: CF
authors: Hung
authors: Wan-Chun
authors: WC
authors: Liao
authors: Ho-Yi
authors: HY
authors: Lei
authors: Min-Chi
authors: MC
authors: Chen
authors: Wei-Lin
authors: WL
authors: Tsai
authors: Shih-Ann
authors: SA
authors: Chen
authors: Clayton Chi-Chang
authors: CC
authors: Chen
authors: Yun-Ching
authors: YC
authors: Fu
authors: Chih-Tai
authors: CT
authors: Ting
mesh_terms: 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