Changes in electrical activation modify the orientation of left ventricular flow momentum: novel observations using echocardiographic particle image velocimetry.
AIMS: Changes in electrical activation sequence are known to affect the timing of cardiac mechanical events. We aim to demonstrate that these also modify global properties of the intraventricular blood flow pattern. We also explore whether such global changes present a relationship with clinical out...
| Published in: | European Heart Journal - Cardiovascular Imaging Vol. 17; no. 2; pp. 203 - 210 |
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| Main Authors: | , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Oxford University Press / USA
Feb2016
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=113072462&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 113072462 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 20472404 BMSM jtl: European Heart Journal - Cardiovascular Imaging issn: 20472404 maglogo: N pubinfo: dt: Feb2016 vid: 17 iid: 2 pid: 622 pub: Oxford University Press / USA artinfo: ui: 113072462 113072462 113072462 10.1093/ehjci/jev137 113072462 ppf: 203 ppct: 7 formats: tig: atl: Changes in electrical activation modify the orientation of left ventricular flow momentum: novel observations using echocardiographic particle image velocimetry. aug: au: Pedrizzetti, Gianni Martiniello, Alfonso R. Bianchi, Valter D'Onofrio, Antonio Caso, Pio Tonti, Giovanni affil: Department of Engineering and Architecture, University of Trieste, P.le Europa 1., Trieste 34127, Italy sug: subj: Athletic Shoes Cardiac Resynchronization Therapy Blood Circulation Heart Failure Computer Terminals Prospective Studies Correlation Coefficient Nonexperimental Studies Confidence Intervals Experimental Studies Quantitative Studies Paired T-Tests Comparative Studies Data Collection Matched-Pair Analysis Reliability ab: AIMS: Changes in electrical activation sequence are known to affect the timing of cardiac mechanical events. We aim to demonstrate that these also modify global properties of the intraventricular blood flow pattern. We also explore whether such global changes present a relationship with clinical outcome. METHODS AND RESULTS: We investigated 30 heart failure patients followed up after cardiac resynchronization therapy (CRT). All subjects underwent echocardiography before implant and at follow-up after 6+ months. Left ventricular mechanics was investigated at follow-up during active CRT and was repeated after a temporary interruption <5 min later. Strain analysis, performed by speckle tracking, was used to assess the entity of contraction (global longitudinal strain) and its synchronicity (standard deviation of time to peak of radial strain). Intraventricular fluid dynamics, by echographic particle image velocimetry, was used to evaluate the directional distribution of global momentum associated with blood motion. The discontinuation of CRT pacing reflects into a reduction of deformation synchrony and into the deviation of blood flow momentum from the base-apex orientation with the development of transversal flow-mediated haemodynamic forces. The deviation of flow momentum presents a significant correlation with the degree of volumetric reduction after CRT. CONCLUSION: Changes in electrical activation alter the orientation of blood flow momentum. The long-term CRT outcome correlates with the degree of re-alignment of haemodynamic forces. These preliminary results suggest that flow orientation could be used for optimizing the biventricular pacing setting. However, larger prospective studies are needed to confirm this hypothesis. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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