Right ventricular dysfunction in patients with Brugada-like electrocardiography: a two dimensional strain imaging
Kazuya Murata1, Takeshi Ueyama, Takeo Tanaka
1Division of Laboratory, Yamaguchi University Hospital, Ube, Japan. kzmurata@yamaguchi-u.ac.jp
Cardiovascular Ultrasound
|November 17, 2011
Summary
Sodium channel blockers impair right ventricular function in Brugada-type ECG patients. Pilsicainide reduced RV strain and worsened myocardial performance indices in the inducible group, indicating global ventricular dysfunction.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Imaging
Background:
- Brugada-type electrocardiography (ECG) is associated with ST-segment elevation.
- Sodium channel blockers are used to provoke ECG responses in Brugada syndrome.
- The impact of sodium channel blockers on ventricular function in Brugada-type ECG is not well understood.
Purpose of the Study:
- To assess the effects of sodium channel blockers on global and regional ventricular function in patients with Brugada-type ECG.
- To evaluate changes in echocardiographic features using Doppler and 2D speckle tracking.
- To investigate the relationship between ECG changes and ventricular performance.
Main Methods:
- Thirty-one patients with Brugada-type ECG were studied.
- Pilsicainide, a sodium channel blocker, was administered to provoke ECG responses.
- Two-dimensional (2D) speckle tracking was used to measure longitudinal systolic myocardial strain in the right ventricle (RV) and interventricular septum.
- Myocardial performance (TEI) indices for both left (LV) and RV were measured.
Main Results:
- A positive ECG response to pilsicainide was observed in 13 patients (inducible group).
- The inducible group showed significantly reduced RV longitudinal strain after pilsicainide administration.
- Both RV and LV TEI indices increased significantly in the inducible group post-pilsicainide.
Conclusions:
- Sodium channel blocker administration leads to deterioration of global ventricular function in Brugada-type ECG patients.
- RV regional function is impaired following sodium channel blocker challenge in patients with coved type ST elevation.
- 2D strain imaging and TEI index analysis are valuable tools for assessing ventricular function changes in Brugada syndrome.
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