scholarly journals Right Ventricular Septal Pacing Preserves Global Left Ventricular Longitudinal Function in Comparison With Apical Pacing

2011 ◽  
Vol 75 (7) ◽  
pp. 1609-1615 ◽  
Author(s):  
Katsuji Inoue ◽  
Hideki Okayama ◽  
Kazuhisa Nishimura ◽  
Makoto Saito ◽  
Toyofumi Yoshii ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Left Ventricular ◽  
Global Left Ventricular ◽  
Longitudinal Function ◽  
Septal Pacing

scholarly journals A new integrated approach to improve left ventricular electromechanical activation during right ventricular septal pacing

EP Europace ◽  
2011 ◽  
Vol 14 (1) ◽  
pp. 92-98 ◽  
Author(s):  
G. Pastore ◽  
S. Aggio ◽  
E. Baracca ◽  
G. Rigatelli ◽  
F. Zanon ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Integrated Approach ◽  
Left Ventricular ◽  
Septal Pacing

scholarly journals P899 Reduced right ventricular longitudinal function in patients with chronic left ventricular disease can be due to left ventricular forward failure and not right ventricular dysfunction

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Fredholm ◽  
S E Ricksten ◽  
K Karason ◽  
S E Bartfay ◽  
G Dellgren ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Peak Systolic Velocity ◽  
Stroke Volume Index ◽  
Left Ventricular ◽  
Right Atrial ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Heart Catheterization ◽  
Ventricular Ejection Fraction ◽  
Longitudinal Function

Abstract Background and aim The occurrence of right ventricular failure (RVF) in patients with chronic left heart disease (LHD) has important therapeutic and prognostic consequences. Echocardiography (Echo) parameters describing the RV longitudinal function (tricuspid annular plane systolic excursion, TAPSE; peak systolic free wall longitudinal strain, RV-Str; tricuspid annulus peak systolic velocity, TAPSm) are today commonly used to define RV dysfunction. In the present study we hypothesised that these parameters are load dependent. Methods We retrospectively included 66 patients with LHD (age 52 ± 13 years, males 79%) that underwent right heart catheterization (RHC) and Echo within 48 hours. RHC was performed as part of diagnostic- or pre-transplant work-up. Fifty-six patients (85%) had left ventricular ejection fraction < 40%. From RHC data the patients were divided into three groups: Patients with RV decompensation and increased right atrial pressure (RAP) ≥10 mmHg (iRAP, n = 21), with normal RAP but reduced stroke volume index (SVI < 35 mL/m2) (rSVI, n = 21) and with normal RAP and normal SVI (nSVI, n = 24). Results Patients with iRAP had compared with rSVI/nSVI more advanced LHD with higher PAMP, PCWP and larger RV diastolic area (RVdA). TAPSE, RV-Str and FAC did not differ between iRAP and rSVI patients. The ratio RVdA/RV-Str was significantly higher in iRAP patients compared with rSVI and nSVI. The rSVI and nSVI patients did not differ regarding RAP response during supine exercise (P = 0.84). Conclusions Reduced RV longitudinal function in patients with chronic LHD and normal RAP can be due to left ventricular forward failure and not RV systolic dysfunction. iRAP (n = 21) rSVI (n = 21) nSVI (n = 24) Overall P-value iRAP vs rSVI iRAP vs nSVI rSVI vs nSVI RAP (mmHg) 13 ± 2 5 ± 3 4 ± 2 <0.001 <0.001 <0.001 0.34 PAMP (mmHg) 33 ± 8 24 ± 8 22±] <0.001 0.001 <0.001 0.34 PCWP (mmHg) 22 ± 5 16 ± 8 11 ± 6 <0.001 0.003 <0.001 0.025 CI (l/min/m2) 2.2 ± 0.4 2.2 ± 0.4 2.8 ± 0.5 <0.001 0.75 <0.001 <0.001 PVR (Wood unit) 2.6 ± 1.2 1.5 ± 1.6 1.9 ± 1.0 0.032 0.022 0.035 0.60 RVdA (cm2) 26 ± 7 21 ± 7 21 ± 5 0.012 0.007 0.017 0.63 TAPSE (mm) 12 ± 3 13 ± 3 18 ± 6 <0.001 0.28 <0.001 0.001 TAPSm (cm/s) 8 ± 2 8 ± 2 10 ± 4 0.06 - - - RV-str (%) -15 ± 5 -17 ± 5 -21 ± 6 0.002 0.11 0.001 0.028 FAC (%) 28 ± 9 29 ± 11 39 ± 11 <0.001 0.72 0.001 0.003 RVdA/RV-str (cm2/%) 2.2 ± 1.3 1.3 ± 0.7 1.1 ± 0.6 <0.001 0.013 0.001 0.27

scholarly journals Right ventricular dysfunction parallels left ventricular functional involvement in women with breast cancer experiencing subclinical cardiotoxicity

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
C Santoro ◽  
R Soloperto ◽  
O Casciano ◽  
R Esposito ◽  
M Lembo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Heart Failure ◽  
Cancer Therapy ◽  
Right Ventricular ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Breast Cancer Patients ◽  
Longitudinal Function ◽  
Oncologic Patients

Abstract Funding Acknowledgements Type of funding sources: None. Background Cancer therapy related cardiac toxicity disease (CRCTD) of the left ventricle (LV)can influence the outcome of oncologic patients. Little is known on CRCTD related right ventricular (RV)dysfunction even though RV involvement has been proven to be a remarkable prognosticator in heart failure. Purpose To analyse parallel changes in LV and RV function occurring during the course of cancer therapy in women affected by breast cancer by using both standard and speckle tracking echocardiography. Methods Fifty Her-2 positive breast cancer women (age = 53.6 ± 11.7 years) underwent sequential cancer therapy protocol including anthracycline (ANT) epirubicine + cyclophosphamide (4 cycles) followed by a total amount of 18 cycles with trastuzumab (TRZ) + paclitaxel. A complete echo-Doppler exam, including LV and RV global longitudinal strain (GLS)as well as RV septal and free wall longitudinal strain (SLS and FWLS respectively) assessment, was performed at baseline, after ANT end and after TRZ completion. Patients with overt heart failure and LV ejection fraction < 50%, coronary artery disease,atrial fibrillation, hemodinamically significant valve disease and inadequate echo were excluded. Overt CRCTD was defined according guidelines and both subclinical LV and RV CRCTD as a LV and RV GLS drop from baseline >15%. Results None of the patients experienced overt CTCRD but 6 patients (14%) showed subclinical LV dysfunction and 33 (66%) had a significant drop of RV longitudinal function.The comparison of standard echo-Doppler exam at baseline and after ANT and TRZ completion did not show significant changes of LV and RV systolic and diastolic parameters. Conversely, a progressive significant reduction of RV GLS (p < 0.002 after TRZ), SLS and FWLS and, with a lower extent, of LV GLS (p < 0.02 after TRZ) was observed after ANT and TRZ completion (Figure). Percentage reduction in RV GLS (DRV GLS) from baseline to ANT end correlated with LV GLS both at EC end (r=-0.40, p = 0.006) and after TRZ completion (r=-0.62, p < 0.0001). Conclusions Detrimental cardiac effects of cancer therapy involve both LV and RV systolic longitudinal function. Progressive RV dysfunction is evident through ANT and TRZ treatment. Early RV dysfunction parallels LV involvement and predicts subsequent LV subclinical dysfunction. A comprehensive LV and RV longitudinal function assessment might better predict the onset of CRCTD in breast cancer patients. Abstract Figure.

Abstract 2823: Right Ventricular Septal Versus Apical Pacing: Long Term Impact On Left Ventricular Synchrony And Function

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Arnold Ng ◽  
Christine Allman ◽  
Jane Vidaic ◽  
Hui Tei ◽  
Andrew P Hopkins ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Circumferential Strain ◽  
Radial Strain ◽  
Left Ventricular ◽  
Volume Index ◽  
Lv Function ◽  
Systolic Volume ◽  
Septal Pacing ◽  
Normal Controls

Background: Right ventricular (RV) septal pacing has been advocated as an alternative to RV apical pacing to avoid long term detrimental effects. There is conflicting evidence on the benefits of RV septal pacing. No studies have previously compared left ventricular (LV) strain and dyssynchrony between different pacing sites and utilized echocardiography to determine pacing sites. Methods: 55 patients (22 normal controls, 17 RV septal and 17 RV apical pacing) were recruited. LV circumferential and radial strain were determined in the midventricular short axis views. Circumferential and radial strain synchrony, and longitudinal systolic (SDTs) and diastolic (SDTe) dyssynchrony indices were determined. Echocardiographic determination of pacing sites were compared with ECG and chest x-ray (CXR). Results: The median pacing durations were 436 days for RV septal and 2398 days for RV apical pacing. Mean QRS duration were significantly shorter for septal than apical pacing and normal controls (139.8 ± 22.6 vs. 162.4 ± 22.9 vs. 85.9 ± 15.2 msec respectively, p < 0.001). LV mass index, end-systolic volume index and ejection fraction were more impaired in RV septal than apical pacing (108.2 ± 27.2 vs. 91.5 ± 15.4 g/m 2 , 21.3 ± 3.7 vs. 19.4 ± 9.3mL/m 2 , 47.6 ± 8.5 vs. 54.2 ± 7.8% respectively, all p < 0.05). RV septal pacing was associated with more impaired circumferential strain (p < 0.001) and worse circumferential strain dyssynchrony (p = 0.02) than apical pacing and normal controls. There were no significant differences in radial strain, radial strain dyssynchrony or SDTs. RV septal pacing consisted of a heterogeneous group of different pacing sites on echocardiography, and there was only modest agreement between echocardiographic, ECG and CXR determinations of pacing sites. Conclusions: RV septal pacing was associated with poorer long term LV function and greater dyssynchrony than RV apical pacing and normal controls.

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