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Title

Improvement in cardiac sympathetic nerve activity in responders to resynchronization therapy

Authors
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
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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. https://archive-ouverte.unige.ch/unige:899

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Deposited on : 2009-02-23

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