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Improvement in cardiac sympathetic nerve activity in responders to resynchronization therapy

Burri, Haran
Somsen, Aernout
Fleury, Eric
Stettler, Carine
Published in Europace. 2008, vol. 10, no. 3, p. 374-8
Abstract AIMS: To assess changes in cardiac adrenergic activity with cardiac resynchronization therapy (CRT), and to investigate whether these changes are related to improvement in left ventricular ejection fraction (LVEF). METHODS AND RESULTS: Sixteen patients (13 males, age 66 +/- 7 years) were studied at baseline and after > or =6 months of CRT (mean follow-up 9.2 +/- 3.2 months). LVEF was assessed by nuclear angiography. Responders were defined as patients showing > or =5% absolute increase in LVEF + improvement in > or =1 NYHA class + absence of heart failure hospitalization. Cardiac sympathetic nerve activity was studied by (123)I-metaiodobenzyl-guanidine ((123)I-MIBG) scintigraphy. Responders (n = 8) showed lower (123)I-MIBG washout at follow-up when compared with non-responders (P = 0.002), indicating lower cardiac sympathetic nerve activity. The decrease in (123)I-MIBG washout at follow-up when compared with baseline was only seen in the responder group (P = 0.036). There was a moderate correlation between increase in LVEF and decrease in (123)I-MIBG washout (r = 0.52, P = 0.04). CONCLUSION: CRT induces a reduction in cardiac sympathetic nerve activity in responders, that parallels an improvement in LVEF, whereas non-responders do not show any significant changes.
Keywords AgedAtrial Fibrillation/therapyCardiac Pacing, Artificial/methodsCardiomyopathies/therapyFemaleFollow-Up StudiesHeart/innervation/radionuclide imagingHumansMaleMiddle AgedPacemaker, ArtificialRadionuclide AngiographyRadionuclide ImagingStroke Volume/physiologySympathetic Nervous System/physiologyVentricular Dysfunction, Left/physiopathology
PMID: 18308757
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Research group Electrophysiologie cardiaque (666)
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BURRI, Haran et al. Improvement in cardiac sympathetic nerve activity in responders to resynchronization therapy. In: Europace, 2008, vol. 10, n° 3, p. 374-8. doi: 10.1093/europace/eun017 https://archive-ouverte.unige.ch/unige:899

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Deposited on : 2009-02-23

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