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1 Department of Cardiology and 2 Department of Radiology, Academic Hospital Maastricht, Cardiovascular Research Institute Maastricht, 6202 AZ Maastricht; and 3 Department of Anatomy and Embryology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
To determine
the nature and time course of biventricular hypertrophy and concomitant
electrical and mechanical changes after creation of complete
atrioventricular block (CAVB), six adult dogs (22-30 kg) were
subjected to serial magnetic resonance imaging (MRI) and
electrocardiography. After 6 days of CAVB, left ventricular (LV) mass,
ejection fraction (EF), and Q-T time at a paced rhythm of 60 beats/min
were already significantly increased. Maximal values were reached
within 14-21 days of CAVB: LV mass, from 116 ± 11 to
143 ± 12 g; right ventricular (RV) mass, from 40 ± 3 to 55 ± 6 g; EF, from 68 ± 6% to 86 ± 5%; and
Q-T time, from 285 ± 25 to 330 ± 35 ms, all
P < 0.05. Cardiac output returned to baseline at
day 14. End-diastolic wall thickness increased only in the
RV, in which angiotensin type 1 (AT1) receptor mRNA
expression was significantly greater. The autopsy correlated well with
the MRI results (r = 0.98, P
0.01). In
conclusion, electrophysiological, mechanical, and structural adaptation
processes after bradycardia-induced volume overload develop rapidly and
are completed within 3 wk. The degree of hypertrophy was greater in the
RV, which was associated with an increase in AT1 receptor mRNA.
structural remodeling; biventricular hypertrophy; repolarization
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