Changes in Left Ventricular Global and Regional Longitudinal Strain During Right Ventricular Pacing

Algazzar, Alaa Solaiman; Katta, Azza Ali; Ahmed, Khaled S.; Elkenany, Nasima Mohamed; Ibrahim, Maher Abdelaleem

doi:10.14740/cr454w

Cited by 10 publications

(4 citation statements)

References 38 publications

(33 reference statements)

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“…In a study by Algazzar et al ., patients with DDD pacemakers were followed up after 6 months post-PPM and found a statistically significant difference in GLS value between preimplantation and postimplantation ( P = 0.01). [ 30 ] A similar study with mostly DDD ( n = 26, 72.2%) patients by Babu et al . also demonstrated a significant decrease in GLS ( P = 0.001) after 6 months post-PPM, from − 17.73% ±3.11% to 13.92% after 6 months.…”

Section: Discussionmentioning

confidence: 76%

Comparison of Global Longitudinal Strain in Dual-chamber versus Ventricular Pacemaker in Complete Heart Block

Laksono,

Yuniadi,

Soesanto

et al. 2024

Journal of Cardiovascular Echography

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Context: Bradycardia caused by total atrioventricular block (TAVB) is treated by implantation of permanent pacemakers (PPMs) in either dual-chamber (DDD) versus ventricular (VVI) pacing modes. DDD is considered a more physiological pacing mode than VVI as it avoids atrioventricular dyssynchrony. However, previous trials have failed to demonstrate the superiority of DDD in improving quality of life and morbidity. Aims: This study aims to provide postpacemaker function of the left ventricle (LV) measured with global longitudinal strain (GLS), in TAVB patients. Settings and Design: This is a comparative study; samples included in the study are adult TAVB patients undergoing PPM implantation, without significant heart function, and structural abnormality. Echocardiographic parameters are obtained before, after 1 month, and after 3 months post-PPM. Subjects and Methods: A total of 98 TAVB patients undergoes PPM implantation during the study period, 55 patients were excluded, and in the end, only 43 patients fulfill the inclusion criteria. Statistical Analysis Used: Baseline data between DDD and VVI are compared using unpaired t-test. Statistical significance 1 month post-PPM and 3 months post-PPM is analyzed using paired t-test. Results: There were no significant differences between both groups at baseline. However, significant GLS changes are observed 1 month after PPM in the VVI group (P = 0.002), but no significant change was observed in the DDD group even after 3 months (P = 0.055). Conclusions: In our study, we conclude that DDD is superior in maintaining LV function in the short term in TAVB patients after PPM implantation.

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Section: Discussionmentioning

confidence: 76%

Comparison of Global Longitudinal Strain in Dual-chamber versus Ventricular Pacemaker in Complete Heart Block

Laksono,

Yuniadi,

Soesanto

et al. 2024

Journal of Cardiovascular Echography

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“…Accurate measurements of LV function are important for risk assessment and management of patients with PPMs. Measurements of LVEF may be insufficient in detecting early signs of dysfunction, as they are derived only from changes to the ventricular lumen and do not reflect sarcomeric shortening 19 . As a result, two‐dimensional speckle tracking GLS assessment has gained widespread use 20,21 .…”

Section: Discussionmentioning

confidence: 99%

“…Measurements of LVEF may be insufficient in detecting early signs of dysfunction, as they are derived only from changes to the ventricular lumen and do not reflect sarcomeric shortening. 19 As a result, two-dimensional speckle tracking GLS assessment has gained widespread use. 20,21 By characterizing myocardial tissue deformation in any direction during the cardiac cycle, reduction in LV GLS measurements can be more reproducible and sensitive for the early detection of LV dysfunction than LVEF.…”

Section: Discussionmentioning

confidence: 99%

Reduction of left ventricular global longitudinal strain in patients with permanent pacemakers as a predictor of heart failure and mortality outcomes

Manocha

Kandola

Kalil

et al. 2023

Pacing Clinical Electrophis

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Introduction:Frequent right ventricular (RV) pacing is associated with cardiomyopathy. The impact of RV pacing on left ventricular (LV) global longitudinal strain (GLS) and clinical outcomes is unclear. Methods:We analyzed GLS via two-dimensional speckle tracking and LV ejection fraction (EF) on pre-and post-implantation transthoracic echocardiograms of patients undergoing dual chamber pacemaker implantation. We collected long-term data on strain, LVEF, and clinical outcomes.Results: One hundred and ten patients (mean age 76 ± 12 years; 59 [54%] female) were followed for mean 23 ± 17 months. Mean baseline LVEF was 58 ± 11% and mean GLS was −17 ± 4%. Twenty-four (22%) patients had an absolute decrease in LVEF > 10% and 43 (39%) patients had a relative reduction of GLS > 15%. Among patients with a reduction of GLS, a larger proportion of patients had RV pacing burden ≥20% (67% vs. 46%; p = .048). Compared to patients without GLS reduction, more patients with a reduction in GLS reached a composite endpoint of HF hospitalization, CRT upgrade or death (47% vs. 16%; p = .001). Conclusion:Reduction in LV GLS was seen in nearly four in 10 patients undergoing pacemaker implantation and was significantly associated with increased RV pacing burden. LV GLS reduction was associated with increased risk of adverse outcomes. LV GLS may have utility in predicting outcomes among patients with RV pacing.

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“…Over the past decade, a number of researchers have been investigating the pathophysiological mechanisms underlying cardiac remodeling after pacemaker implantation and their results suggest a multifactorial process [8]. A common principle in the development of myocardial contractility disorder is remodeling of the extracellular matrix at the expense of enhanced replacement interstitial fibrosis [9].…”

Section: Introductionmentioning

confidence: 99%

Relationship between CTGF levels and echocardiographic parameters in patients after permanent pacemaker implantation

Ivaneta Dimitrova Yoncheva,

Mariya Negrinova Negreva

2023

World J. Adv. Res. Rev.

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Introduction: In recent decades, the dual-chamber pacemaker has become the gold standard for treating high-degree atrioventricular block. Despite the incredible benefits of overcoming conduction disorders, undeniable evidence has accumulated in recent years of negative effects of permanent right ventricular apical stimulation. The aim of our study was to examine the cytokines responsible for activation of the fibrotic process in patients after PPM implantation with apical right ventricular stimulation. Material and Methods: CTGF levels were investigated by enzyme-linked immunoassays in plasma from 45 patients (25 men, 20 women, aged 72.1±9 years) and 46 controls (24 men, 22 women, aged 71.9±8.7 years) without known cardiovascular diseases (except arterial hypertension, conduction disorder, indication for the procedure) at baseline (for patients immediately before PPM implantation), at 12 and 24 weeks. At the same visits echocardiography was performed. Results: There was no difference in baseline CTGF levels between patients and controls (312.66±15.25 vs 313.05±12.98 p>0.05). In patients, at week 12, CTGF levels were significantly increased compared to baseline in controls (627.74±41.81 vs 313.05±12.98 pg/ml p<0.001). At week 24, values continued to increase, being again significantly higher than baseline in controls (400.83±13.29 vs 313.05±12.98 pg/ml p<0.001). Conclusion: Our data analysis gives us reason to conclude that there is a significant increase in the levels of the growth factor after PPM implantation and it plays a major role in fibrotic remodeling of the myocardium. We guess increase in filling pressure of the left ventricle that is followed by LA pressure load and is a prerequisite for its dilatation.

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Changes in Left Ventricular Global and Regional Longitudinal Strain During Right Ventricular Pacing

Cited by 10 publications

References 38 publications

Comparison of Global Longitudinal Strain in Dual-chamber versus Ventricular Pacemaker in Complete Heart Block

Comparison of Global Longitudinal Strain in Dual-chamber versus Ventricular Pacemaker in Complete Heart Block

Reduction of left ventricular global longitudinal strain in patients with permanent pacemakers as a predictor of heart failure and mortality outcomes

Relationship between CTGF levels and echocardiographic parameters in patients after permanent pacemaker implantation

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