geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Reverse electrophysiologic remodeling after cardiac mechanical unloading for end-stage nonischemic cardiomyopathy


, : Reverse electrophysiologic remodeling after cardiac mechanical unloading for end-stage nonischemic cardiomyopathy. Annals of Thoracic Surgery 91(3): 764-769

Left ventricular assist devices (LVAD)-induced unloading appear to cause reverse cardiac remodeling. However, its effect on arrhythmogenicity is a controversial issue, and prospective data are lacking. We sought to investigate the impact of LVAD-induced unloading on the electrical properties of the failing heart. We prospectively studied the effects of LVAD therapy on QRS, QT, and QTc durations and ventricular arrhythmias from electrocardiograms and 24-hour ambulatory electrocardiograms recorded before and during 6 months of mechanical support in 12 LVAD patients and 7 other patients with advanced nonischemic cardiomyopathy untreated with LVAD. After 1 week of LVAD support, QTc duration had decreased from 479 ± 79 ms to 411 ± 57 ms (p = 0.037), and QRS duration from 150 ± 46 ms to 134 ± 32 ms (p = 0.029). At 6 months, QTc was found to be 372 ± 56 ms (p = 0.046 versus baseline, 15% shortening) and QRS 118 ± 25 ms (p = 0.028 versus baseline, 11% shortening). A strong correlation was found between QTc shortening and increase in left ventricular ejection fraction and decrease in left ventricular filling pressures. After 2 months of LVAD support, premature ventricular contractions had decreased from 3,507 ± 4,252 to 483 ± 417 in 24 hours (p = 0.043), ventricular couplets from 82 ± 99 to 29 ± 25 in 24 hours (p = 0.05), and ventricular runs from 9 ± 8 to 10 ± 9 (not significant). No patient died suddenly or suffered a symptomatic arrhythmic event during follow-up. No significant electrocardiographic, functional, or hemodynamic change was observed in the 7 patients untreated with LVAD. The LVAD support caused progressive shortening of QTc and QRS intervals, consistent with reverse remodeling of the failing heart's electrical properties, accompanied by a decrease in frequency of ventricular arrhythmias.

US$19.90

PMID: 21352994

DOI: 10.1016/j.athoracsur.2010.10.091


Other references

Butters, R.R.; Chattopadhyay, N.; Nielsen, P.; Smith, C.P.; Mithal, A.; Kifor, O.; Bai, M.; Quinn, S.; Goldsmith, P.; Hurwitz, S.; Krapcho, K.; Busby, J.; Brown, E.M., 1997: Cloning and characterization of a calcium-sensing receptor from the hypercalcemic New Zealand white rabbit reveals unaltered responsiveness to extracellular calcium. The extracellular Ca-2+ (Ca-0-2+)-sensing receptor (CaR) recently cloned from mammalian parathyroid, kidney, brain, and thyroid plays a central role in maintaining near constancy of Ca-0-2+. We previously showed that the hypercalcemia normally pre...

Buondonno, C.; Ermice, A.; Buondonno, A.; Murolo, M.; Pugliano, M.L., 1998: Human-influenced soils from an iron and steel works in Naples, Italy. The study of soils formed by human activities is one of the concerns of modern pedology. In Italy, data on highly human-disturbed soils are not availiable. We investigated the soils from a recently dismantled iron and steel production plant, and c...

Marek Charles R., 1992: Proposed standard for sizes of stone for erosion control. ASTM Special Technical Publication = American Society for Testing and Materials Special Technical Publication Pages 122-130

Seaborg G.T., 1975: The occurrence of the transuranium elements in nature. Pages 628-632 1975

Kilburn, F.L.; Bailey, P.; Price, D., 2013: Sepsis: recognizing the next event. Nursing 43(10): 14-16

Schiffer, M., 1952: Mathematical studies in animal populations I A mathematical study of insect parasitism. Continuing the analyses of Thompson of parasitation cycles in insects, the present paper analyzes some of the reasons why parasites almost never exterminate in nature their host and thus themselves. The main reason is a steady incidence of catastr...

Columba Teru, V.; Manu, S.A.; Ahmed, G.I.; Junaidu, K.; Newman, S.; Nyager, J.; Iwar, V.N.; Mshelbwala, G.M.; Joannis, T.; Maina, J.A.; Apeverga, P.T., 2012: Situation-based survey of avian influenza viruses in possible "bridge" species of wild and domestic birds in Nigeria. The highly pathogenic avian influenza (H5N1 subtype) recurred in Nigeria after 9 months period of no reported case. A critical look at possible sources of the re-occurrence was desirable. The objective of this study was to determine whether avian...

Huang, J.C.; Liu, Y.C., 1993: Relationship between oxygen flux and biofilm performance. The relationship between the availability of dissolved oxygen in a laboratory-scale biofilm reactor and some performance parameters was investigated. Parameters studied included biofilm growth rate, organic stabilisation rate, sulfide production p...

Camping, M.W., 1954: Bijdrage tot de kennis van de Macrolepidoptera van Vlieland II. Entomologische Berichten Amsterdam, 15: 165-170

Nakamatsu, T.; Beppu, T.; Arima, K., 1983: Microbial production of 3a alpha h 4 alpha 3' propionic acid 5 alpha hydroxy 7a beta methyl hexa hydro 1 indanone delta lactone from soybean sterol. Fermentative production of 3a.alpha.-H-4.alpha.-(3'-propionic acid)-5.alpha.-hydroxy-7a.beta.-methylhexahydro-1-indanone-.delta.-lactone (HIL) from soybean sterol was studied in order to use it as an intermediate for chemical synthesis of 19-...