| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
|
|
|
|||||||
|
|||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1 Cardiology, Erasme Hospital, Brussels, Belgium
2 Cardiology, UCL Mont-Godinne, Mont-Godinne, Belgium
3 Cardiology, CHU Tivoli, La Louviere, Belgium
4 Cardiology, CHU St Pierre, Brussels, United States
* To whom correspondence should be addressed. E-mail: bnajem{at}ulb.ac.be.
Introduction: Cardiac resynchronization therapy (CRT) decreases muscle sympathetic nerve activity (MSNA) in patients with severe congestive heart failure (CHF) and cardiac asynchrony. Whether this affects equally patients who clinically respond or not to CRT is unknown. We tested the hypothesis that the favorable effects of CRT on MSNA disappear upon CRT interruption only in those who respond to CRT. Method: Twenty-three consecutive CHF patients participated in the study, among whom 16 presented a symptomatic improvement by one or more NYHA functional classes 15+/-5 months after CRT (responders), and 7 had not improved after 12+/-4 months of CRT (nonresponders). MSNA and echocardiographic recordings were obtained in random order during atrio-right ventricular pacing (ARV), without stimulation in patients who were not pacemaker dependent (OFF, n=17), and during atrio-biventricular pacing (BIV). Results: Responders had a longer 6 min walking distance, a lower NYHA class and BNP levels, and a better quality of life, than nonresponders (all p<0.05). MSNA increased by 25+/-7% in the responders, whereas it remained unchanged in the nonresponders, when shifting from the BIV mode to a non synchronous condition (ARV and OFF modes) (p<0.01). Cardiac output decreased by 0.7+/-0.2 l/min in the responders, but did not change when shifting from the BIV mode to the non synchronous pacing mode in the nonresponders, (p<0.01). Conclusion: Reversible sympathoinhibition is a marker of the clinical response to CRT.
This article has been cited by other articles:
|
|
 |
|
  M. G. J. Gademan, R. J. van Bommel, C. J. W. Borleffs, S. Man, J. C. W. Haest, M. J. Schalij, E. E. van der Wall, J. J. Bax, and C. A. Swenne Biventricular pacing-induced acute response in baroreflex sensitivity has predictive value for midterm response to cardiac resynchronization therapy Am J Physiol Heart Circ Physiol, July 1, 2009; 297(1): H233 - H237. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Chakir, S. K. Daya, T. Aiba, R. S. Tunin, V. L. Dimaano, T. P. Abraham, K. Jaques, E. W. Lai, K. Pacak, W.-Z. Zhu, et al. Mechanisms of Enhanced {beta}-Adrenergic Reserve From Cardiac Resynchronization Therapy Circulation, March 10, 2009; 119(9): 1231 - 1240. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. G. J. Gademan, R. J. van Bommel, C. Ypenburg, J. C. W. Haest, M. J. Schalij, E. E. van der Wall, J. J. Bax, and C. A. Swenne Biventricular pacing in chronic heart failure acutely facilitates the arterial baroreflex Am J Physiol Heart Circ Physiol, August 1, 2008; 295(2): H755 - H760. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Burri, H. Sunthorn, A. Somsen, E. Fleury, C. Stettler, D. Shah, and A. Righetti Improvement in cardiac sympathetic nerve activity in responders to resynchronization therapy Europace, March 1, 2008; 10(3): 374 - 378. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Vanderheyden, W. Mullens, L. Delrue, M. Goethals, B. de Bruyne, W. Wijns, P. Geelen, S. Verstreken, F. Wellens, and J. Bartunek Myocardial Gene Expression in Heart Failure Patients Treated With Cardiac Resynchronization Therapy: Responders Versus Nonresponders J. Am. Coll. Cardiol., January 15, 2008; 51(2): 129 - 136. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Gould, G. Kong, V. Kalff, S. J. Duffy, A. J. Taylor, M. J. Kelly, and D. M. Kaye Improvement in cardiac adrenergic function post biventricular pacing for heart failure Europace, September 1, 2007; 9(9): 751 - 756. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. R. Bristow Cardiac resynchronization therapy and adrenergic mechanisms Am J Physiol Heart Circ Physiol, December 1, 2006; 291(6): H2590 - H2591. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
| Visit Other APS Journals Online |
