Interactions between myocardial sympathetic denervation and left ventricular mechanical dyssynchrony: A CZT analysis View Full Text


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Article Info

DATE

2019-04

AUTHORS

Alessia Gimelli, Riccardo Liga, Francesca Menichetti, Ezio Soldati, Maria Grazia Bongiorni, Paolo Marzullo

ABSTRACT

BACKGROUND: A correlation between left ventricular (LV) dyssynchrony (LVD) and impaired myocardial sympathetic tone has been hypothesized. We sought to assess the interactions between regional LV sympathetic innervation, perfusion, and mechanical dyssynchrony. METHODS: Eighty-three patients underwent evaluation of LV perfusion and sympathetic innervation on 99mTc-tetrofosmin/123I-metaiodobenzylguanidine (123I-MIBG) imaging. The summed rest score and summed 123I-MIBG score (SS-MIBG) were computed. The extent of "innervation/perfusion" mismatch was defined as the number of denervated LV segments with relatively preserved perfusion. LVD was evaluated on phase analysis and the wall with latest mechanical activation identified. RESULTS: LVD was revealed in 36 (43%) patients. Patients with LVD had more abnormal values of SRS (21 ± 9 vs 10 ± 8, P < 0.001) and SS-MIBG (29 ± 9 vs 17 ± 11, P < 0.001) than those without LVD. The presence of LVD also clustered with a higher burden of "innervation/perfusion" mismatch (P = 0.019). On per-wall analysis, LV walls with delayed mechanical activation showed a higher burden of "innervation/perfusion" mismatch (2.3 ± 1.4 segments) than normally contracting walls (1.3 ± 1.2 segments; P < 0.001). On multivariate analysis, the extent of "innervation/perfusion" mismatch was the only predictor of delayed mechanical activation (P = 0.029). CONCLUSIONS: Patients with LVD show an elevated burden of "innervation/perfusion" mismatch that is concentrated at the level of the most dyssynchronous walls. More... »

PAGES

509-518

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    URI

    http://scigraph.springernature.com/pub.10.1007/s12350-017-1036-3

    DOI

    http://dx.doi.org/10.1007/s12350-017-1036-3

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1091212598

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/28808889


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        "description": "BACKGROUND: A correlation between left ventricular (LV) dyssynchrony (LVD) and impaired myocardial sympathetic tone has been hypothesized. We sought to assess the interactions between regional LV sympathetic innervation, perfusion, and mechanical dyssynchrony.\nMETHODS: Eighty-three patients underwent evaluation of LV perfusion and sympathetic innervation on 99mTc-tetrofosmin/123I-metaiodobenzylguanidine (123I-MIBG) imaging. The summed rest score and summed 123I-MIBG score (SS-MIBG) were computed. The extent of \"innervation/perfusion\" mismatch was defined as the number of denervated LV segments with relatively preserved perfusion. LVD was evaluated on phase analysis and the wall with latest mechanical activation identified.\nRESULTS: LVD was revealed in 36 (43%) patients. Patients with LVD had more abnormal values of SRS (21\u00a0\u00b1\u00a09 vs 10\u00a0\u00b1\u00a08, P\u00a0<\u00a00.001) and SS-MIBG (29\u00a0\u00b1\u00a09 vs 17\u00a0\u00b1\u00a011, P\u00a0<\u00a00.001) than those without LVD. The presence of LVD also clustered with a higher burden of \"innervation/perfusion\" mismatch (P\u00a0=\u00a00.019). On per-wall analysis, LV walls with delayed mechanical activation showed a higher burden of \"innervation/perfusion\" mismatch (2.3\u00a0\u00b1\u00a01.4 segments) than normally contracting walls (1.3\u00a0\u00b1\u00a01.2 segments; P\u00a0<\u00a00.001). On multivariate analysis, the extent of \"innervation/perfusion\" mismatch was the only predictor of delayed mechanical activation (P\u00a0=\u00a00.029).\nCONCLUSIONS: Patients with LVD show an elevated burden of \"innervation/perfusion\" mismatch that is concentrated at the level of the most dyssynchronous walls.", 
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