Tags

Type your tag names separated by a space and hit enter

Interventricular mechanical asynchrony in pulmonary arterial hypertension: left-to-right delay in peak shortening is related to right ventricular overload and left ventricular underfilling.
J Am Coll Cardiol. 2008 Feb 19; 51(7):750-7.JACC

Abstract

OBJECTIVES

The purpose of this study was to explore in pulmonary arterial hypertension (PAH) whether the cause of interventricular asynchrony lies in onset of shortening or duration of shortening.

BACKGROUND

In PAH, leftward ventricular septal bowing (LVSB) is probably caused by a left-to-right (L-R) delay in myocardial shortening.

METHODS

In 21 PAH patients (mean pulmonary arterial pressure 55 +/- 13 mm Hg and electrocardiogram-QRS width 100 +/- 16 ms), magnetic resonance imaging myocardial tagging (14 ms temporal resolution) was applied. For the left ventricular (LV) free wall, septum, and right ventricular (RV) free wall, the onset time (T(onset)) and peak time (T(peak)) of circumferential shortening were calculated. The RV wall tension was estimated by the Laplace law.

RESULTS

The T(onset) was 51 +/- 23 ms, 65 +/- 4 ms, and 52 +/- 22 ms for LV, septum, and RV, respectively. The T(peak) was 293 +/- 58 ms, 267 +/- 22 ms, and 387 +/- 50 ms for LV, septum, and RV, respectively. Maximum LVSB was at 395 +/- 45 ms, coinciding with septal overstretch and RV T(peak). The L-R delay in T(onset) was -1 +/- 16 ms (p = 0.84), and the L-R delay in T(peak) was 94 +/- 41 ms (p < 0.001). The L-R delay in T(peak) was not related to the QRS width but was associated with RV wall tension (p < 0.05). The L-R delay in T(peak) correlated with leftward septal curvature (p < 0.05) and correlated negatively with LV end-diastolic volume (p < 0.05) and stroke volume (p < 0.05).

CONCLUSIONS

In PAH, the L-R delay in myocardial peak shortening is caused by lengthening of the duration of RV shortening. This L-R delay is related to LVSB, decreased LV filling, and decreased stroke volume.

Authors+Show Affiliations

Department of Physics and Medical Technology, Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, the Netherlands. jt.marcus@vumc.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18279740

Citation

Marcus, J Tim, et al. "Interventricular Mechanical Asynchrony in Pulmonary Arterial Hypertension: Left-to-right Delay in Peak Shortening Is Related to Right Ventricular Overload and Left Ventricular Underfilling." Journal of the American College of Cardiology, vol. 51, no. 7, 2008, pp. 750-7.
Marcus JT, Gan CT, Zwanenburg JJ, et al. Interventricular mechanical asynchrony in pulmonary arterial hypertension: left-to-right delay in peak shortening is related to right ventricular overload and left ventricular underfilling. J Am Coll Cardiol. 2008;51(7):750-7.
Marcus, J. T., Gan, C. T., Zwanenburg, J. J., Boonstra, A., Allaart, C. P., Götte, M. J., & Vonk-Noordegraaf, A. (2008). Interventricular mechanical asynchrony in pulmonary arterial hypertension: left-to-right delay in peak shortening is related to right ventricular overload and left ventricular underfilling. Journal of the American College of Cardiology, 51(7), 750-7. https://doi.org/10.1016/j.jacc.2007.10.041
Marcus JT, et al. Interventricular Mechanical Asynchrony in Pulmonary Arterial Hypertension: Left-to-right Delay in Peak Shortening Is Related to Right Ventricular Overload and Left Ventricular Underfilling. J Am Coll Cardiol. 2008 Feb 19;51(7):750-7. PubMed PMID: 18279740.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Interventricular mechanical asynchrony in pulmonary arterial hypertension: left-to-right delay in peak shortening is related to right ventricular overload and left ventricular underfilling. AU - Marcus,J Tim, AU - Gan,C Tji-Joong, AU - Zwanenburg,Jaco J M, AU - Boonstra,Anco, AU - Allaart,Cor P, AU - Götte,Marco J W, AU - Vonk-Noordegraaf,Anton, PY - 2006/08/08/received PY - 2007/10/10/revised PY - 2007/10/22/accepted PY - 2008/2/19/pubmed PY - 2008/3/13/medline PY - 2008/2/19/entrez SP - 750 EP - 7 JF - Journal of the American College of Cardiology JO - J. Am. Coll. Cardiol. VL - 51 IS - 7 N2 - OBJECTIVES: The purpose of this study was to explore in pulmonary arterial hypertension (PAH) whether the cause of interventricular asynchrony lies in onset of shortening or duration of shortening. BACKGROUND: In PAH, leftward ventricular septal bowing (LVSB) is probably caused by a left-to-right (L-R) delay in myocardial shortening. METHODS: In 21 PAH patients (mean pulmonary arterial pressure 55 +/- 13 mm Hg and electrocardiogram-QRS width 100 +/- 16 ms), magnetic resonance imaging myocardial tagging (14 ms temporal resolution) was applied. For the left ventricular (LV) free wall, septum, and right ventricular (RV) free wall, the onset time (T(onset)) and peak time (T(peak)) of circumferential shortening were calculated. The RV wall tension was estimated by the Laplace law. RESULTS: The T(onset) was 51 +/- 23 ms, 65 +/- 4 ms, and 52 +/- 22 ms for LV, septum, and RV, respectively. The T(peak) was 293 +/- 58 ms, 267 +/- 22 ms, and 387 +/- 50 ms for LV, septum, and RV, respectively. Maximum LVSB was at 395 +/- 45 ms, coinciding with septal overstretch and RV T(peak). The L-R delay in T(onset) was -1 +/- 16 ms (p = 0.84), and the L-R delay in T(peak) was 94 +/- 41 ms (p < 0.001). The L-R delay in T(peak) was not related to the QRS width but was associated with RV wall tension (p < 0.05). The L-R delay in T(peak) correlated with leftward septal curvature (p < 0.05) and correlated negatively with LV end-diastolic volume (p < 0.05) and stroke volume (p < 0.05). CONCLUSIONS: In PAH, the L-R delay in myocardial peak shortening is caused by lengthening of the duration of RV shortening. This L-R delay is related to LVSB, decreased LV filling, and decreased stroke volume. SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/18279740/Interventricular_mechanical_asynchrony_in_pulmonary_arterial_hypertension:_left_to_right_delay_in_peak_shortening_is_related_to_right_ventricular_overload_and_left_ventricular_underfilling_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(07)03746-1 DB - PRIME DP - Unbound Medicine ER -