Skip Navigation



European Heart Journal Advance Access published online on November 16, 2005
European Heart Journal, doi:10.1093/eurheartj/ehi579
This Article
Right arrow Full Text (Rapid PDF)
Right arrow All Versions of this Article:
27/2/201    most recent
ehi579v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by D'Ascia, C.
Right arrow Articles by Saccà, L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by D'Ascia, C.
Right arrow Articles by Saccà, L.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

European Heart Journal © The European Society of Cardiology 2005; all rights reserved
Received November 3, 2004
Revised July 29, 2005
Accepted September 15, 2005

Clinical research

Effects of biventricular pacing on interstitial remodelling, tumor necrosis factor-{alpha} expression, and apoptotic death in failing human myocardium

Cristoforo D'Ascia 1, Antonio Cittadini 1, Maria Gaia Monti 1, Giuseppe Riccio 1, and Luigi Saccà 1 *

1 Department of Internal Medicine and Cardiovascular Sciences, University Federico II, Via Sergio Pansini 5, 80131 Naples, Italy

* To whom correspondence should be addressed.
Luigi Saccà, E-mail: sacca{at}unina.it


  Abstract

Aims Recent data from the COMPANION trial have documented that cardiac resynchronization therapy (CRT) with biventricular (BiV) pacing reduces mortality and hospitalization in patients with advanced CHF, but little is known regarding the cellular and molecular mechanisms of CRT. Our aim is to evaluate interstitial remodelling, tumor necrosis factor-{alpha} (TNF-{alpha}) expression, and apoptosis in patients with advanced CHF treated with CRT.

Methods and results We performed endomyocardial biopsies in 10 patients, aged 62, with dilated cardiomyopathy before and 6 months after the implantation of a BiV pacing device. Clinical status and left ventricular (LV) architecture and function were assessed as well as myocardial histology, TNF-{alpha} expression, and apoptotic index. CRT improved clinical status, as shown by a significant reduction of the Minnesota living with heart failure questionnaire (MLHFQ) score (from 53 to 40) and 6-min walked distance (from 290 to 330 m) (all P < 0.05 vs. baseline). This was associated with reverse LV remodelling substantiated by significant reductions of LV volumes and end-systolic circumferential wall stress. Examination of myocardial tissue revealed a significant decrease of collagen volume fraction (CVF) (from 25.16 to 18.0%), TNF-{alpha} expression (from 9.5 to 3.6 pixel x 103), and apoptotic index (from 2030 to 1408 apoptotic nuclei/106), with increased capillary density (from 1801 to 2011 capillary/mm2) after 6 months of CRT (all P < 0.05 vs. baseline). Moreover, changes in TNF-{alpha} expression were positively correlated with both CVF and end-systolic circumferential wall stress (r = 0.80 and 0.70, respectively).

Conclusion We provide the first evidence that CRT reduces interstitial remodelling, TNF-{alpha} expression, and apoptosis. The data may explain the beneficial effects of CRT on CHF progression and survival.

Keywords: Heart failure; Pacing; Collagen Apoptosis; Resynchronization therapy.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 CirculationHome page
K. Chakir, S. K. Daya, T. Aiba, R. S. Tunin, V. L. Dimaano, T. P. Abraham, K. Jaques, E. W. Lai, K. Pacak, W.-Z. Zhu, et al.
Mechanisms of Enhanced {beta}-Adrenergic Reserve From Cardiac Resynchronization Therapy
Circulation, March 10, 2009; 119(9): 1231 - 1240.
[Abstract] [Full Text] [PDF]

Home page
 StrokeHome page
J.-M. Li, M. Mogi, J. Iwanami, L.-J. Min, K. Tsukuda, A. Sakata, T. Fujita, M. Iwai, and M. Horiuchi
Temporary Pretreatment With the Angiotensin II Type 1 Receptor Blocker, Valsartan, Prevents Ischemic Brain Damage Through an Increase in Capillary Density
Stroke, July 1, 2008; 39(7): 2029 - 2036.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
I. Garcia-Bolao, B. Lopez, A. Macias, J. J. Gavira, P. Azcarate, and J. Diez
Impact of collagen type I turnover on the long-term response to cardiac resynchronization therapy
Eur. Heart J., April 1, 2008; 29(7): 898 - 906.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
K. Chakir, S. K. Daya, R. S. Tunin, R. H. Helm, M. J. Byrne, V. L. Dimaano, A. C. Lardo, T. P. Abraham, G. F. Tomaselli, and D. A. Kass
Reversal of Global Apoptosis and Regional Stress Kinase Activation by Cardiac Resynchronization
Circulation, March 18, 2008; 117(11): 1369 - 1377.
[Abstract] [Full Text] [PDF]

Home page
 Cardiovasc ResHome page
J. J. Gavira, M. Perez-Ilzarbe, G. Abizanda, A. Garcia-Rodriguez, J. Orbe, J. A. Paramo, M. Belzunce, G. Rabago, J. Barba, J. Herreros, et al.
A comparison between percutaneous and surgical transplantation of autologous skeletal myoblasts in a swine model of chronic myocardial infarction
Cardiovasc Res, September 1, 2006; 71(4): 744 - 753.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.