Wall motion asynchrony prolongs time constant of left ventricular relaxation

To evaluate the effects of wall motion asynchrony on left ventricular (LV) relaxation, we performed atrioventricular sequential pacing with the second stimulation at six epicardial sites in open-chest anesthetized dogs. Myocardial segment lengths in the basal, mid, and apical LV free wall were measured by ultrasonic crystals. The standard deviation of interval from the onset of the QRS complex to that of elongation in each segment length was used as a quantitative index for asynchrony (asynchrony index, AI). The AI increased significantly in all sequential pacing modes compared with the control right atrial pacing. The time constant (T) of LV relaxation derived from exponential fit with zero-asymptote was prolonged significantly in all sequential pacing modes except for pacing at the LV base. In each dog there was a good correlation between changes in AI and T [r = 0.61 - 0.98 (mean = 0.84)]. Since the regional inactivation process of the myocardium is considered to be unchanged during these interventions, we concluded that asynchronous wall motion plays an important role in the impairment of LV relaxation.