European Heart Journal Advance Access originally published online on July 4, 2007
European Heart Journal 2007 28(17):2148-2155; doi:10.1093/eurheartj/ehm207
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Cardiac resynchronization therapy cures dyssynchronopathy in canine left bundle-branch block hearts
1 Department of Physiology, Cardiovascular Research Institute Maastricht, PO Box 616, 6200 MD, Maastricht, the Netherlands
2 Department of Biophysics, Cardiovascular Research Institute Maastricht, PO Box 616, 6200 MD, Maastricht, the Netherlands
3 Department of Cardiology, Cardiovascular Research Institute Maastricht, PO Box 616, 6200 MD, Maastricht, the Netherlands
4 Medtronic Bakken Research Center, Maastricht, The Netherlands
Received 8 June 2006; revised 10 April 2007; accepted 3 May 2007; online publish-ahead-of-print 4 July 2007.
* Corresponding author. Tel: +31 43 3881200; fax: +31 43 3884166. E-mail address: K.Vernooy{at}fys.unimaas.nl
Aims: We investigated to what extent biventricular pacing (BVP) can normalize LV function and remodeling, induced by isolated left bundle branch block (LBBB).
Methods and results: In 16 dogs LBBB was induced. Eight animals were followed for 16 weeks and in 8 animals BVP was started after 8 weeks. LV pressure, LV geometry (2Dechocardiography), systolic circumferential shortening (CSsys, MRI tagging) and myocardial blood flow (MBF, microspheres) was measured. * and # indicate P < 0.05 compared to pre-LBBB and 8 weeks of LBBB, respectively. Data is presented relative to pre-LBBB values (mean ± SEM). BVP increased LV dP/dt|max from 78 ± 5%* to 86 ± 5%*# (immediately) and 89 ± 6%# (after 8 weeks) and normalized regional differences in CSsys and MBF. After 8 weeks of BVP, LV end-diastolic volume (EDV) was reduced from 123 ± 3%* to 109 ± 6%# and LV lateral wall mass was reduced from 128 ± 5%* to 113 ± 3%*#. The acute increase in LV dP/dt|max upon BVP correlated with LV EDV and LV wall mass after 8 weeks of BVP.
Conclusion: In canine hearts with long-term isolated LBBB, BVP largely reverses global and regional functional and structural abnormalities induced by LBBB.
Key Words: Cardiac resynchronization therapy • Bundle-branch block • Remodelling • Haemodynamics • Magnetic resonance imaging
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