Effects of biventricular pacing on left heart twist and strain in a porcine model of right heart failure

Abstract Background Biventricular pacing (BiVP) improves cardiac output (CO) in selected cardiac surgery patients, but response remains variable, necessitating a better understanding of the mechanism. Accordingly, we used speckle tracking echocardiography (STE) to analyze BiVP during acute right ven...

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Bibliographic Details
Published in:The Journal of surgical research 2013-12, Vol.185 (2), p.645-652
Main Authors: Wang, Alice, MD, Cabreriza, Santos E., MBA, Havalad, Vinod, MD, Aponte-Patel, Linda, MD, Gonzalez, Gerardo, Velez de Villa, Bryan, BS, Cheng, Bin, PhD, Spotnitz, Henry M., MD
Format: Article
Language:English
Subjects:
Animals
Biventricular pacing
Cardiac Output - physiology
Cardiac Resynchronization Therapy - methods
Disease Models, Animal
Echocardiography - methods
Heart Block - diagnostic imaging
Heart Block - physiopathology
Heart Block - therapy
Heart Failure - diagnostic imaging
Heart Failure - physiopathology
Heart Failure - therapy
Hypertension, Pulmonary - diagnostic imaging
Hypertension, Pulmonary - physiopathology
Hypertension, Pulmonary - therapy
Male
Myocardial Contraction - physiology
Right ventricular pressure overload
Speckle tracking echocardiography
Surgery
Swine
Torsion, Mechanical
Vena Cava, Inferior - physiopathology
Ventricular Pressure - physiology
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Summary:Abstract Background Biventricular pacing (BiVP) improves cardiac output (CO) in selected cardiac surgery patients, but response remains variable, necessitating a better understanding of the mechanism. Accordingly, we used speckle tracking echocardiography (STE) to analyze BiVP during acute right ventricular pressure overload (RVPO). Materials and methods In nine pigs, the inferior vena cava (IVC) was snared to decrease CO and establish a control model. Heart block was induced, the pulmonary artery snared, and BiVP initiated. Echocardiograms of the left ventricular midpapillary level were taken at varying atrioventricular delay (AVD) and interventricular delay (VVD) for STE analysis of regional circumferential strain (CS) and radial strain (RS). Echocardiograms were taken of the left ventricular base, midpapillary, and apex during baseline, IVC occlusion, and each BiVP setting for STE analysis of twist, apical and basal rotations, CS, RS, and synchrony. Indices were correlated against CO with mixed linear models. Results During IVC occlusion, CO correlated with twist, apical rotation, RS, RS synchrony, and CS ( P < 0.05). During RVPO with BiVP, CO only correlated with RS synchrony and CS ( P  
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2013.06.038