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European Heart Journal Advance Access originally published online on November 30, 2004
European Heart Journal 2005 26(1):70-76; doi:10.1093/eurheartj/ehi046
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Clinical research

Effect of cardiac resynchronization therapy on global and regional oxygen consumption and myocardial blood flow in patients with non-ischaemic and ischaemic cardiomyopathy

Oliver Lindner1,*, Jürgen Vogt2, Annett Kammeier1, Peter Wielepp1, Jens Holzinger2, Detlev Baller2, Barbara Lamp2, Bert Hansky3, Reiner Körfer3, Dieter Horstkotte2 and Wolfgang Burchert1

1Institute of Molecular Biophysics, Radiopharmacy, and Nuclear Medicine, Heart and Diabetes Center North Rhine-Westphalia, Georgstr. 11, D-32545 Bad Oeynhausen, Germany
2Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany
3Department of Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany

Received March 10, 2004; revised September 20, 2004; accepted October 14, 2004 * Corresponding author. Tel: +49 5731 97 1309; fax: +49 5731 97 2190.  E-mail address: olindner{at}hdz-nrw.de

Aims 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).

Methods and 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.

Conclusion 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.

Key Words: Cardiomyopathy • Bundle branch block • Pacing • Oxygen • Perfusion • Positron emission tomography


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