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Related Concept Videos

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Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
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Echocardiographic Measurement of Right Ventricular Diastolic Parameters in Mouse
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Strain echocardiography in predicting LV dysfunction in RV apical pacing.

Goutam Datta1, Dipankar Ghosh Dastidar1, Hrishikesh Chakraborty1

  • 1Department of Cardiology, Burdwan Medical College, Burdwan, India.

Indian Heart Journal
|January 5, 2023
PubMed
Summary
This summary is machine-generated.

Right ventricular pacing can cause heart failure. Strain imaging detected early left ventricular dysfunction in patients with pacemakers, aiding timely intervention for pacing-induced cardiomyopathy.

Keywords:
GLSHeart failureLV dysfunctionRV apical pacingStrain Echocardiography

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Area of Science:

  • Cardiology
  • Medical Imaging
  • Electrophysiology

Background:

  • Right ventricular (RV) pacing is linked to reduced left ventricular (LV) systolic function, potentially due to pacing-induced dyssynchrony.
  • Heart failure prevalence post-RV pacing is significant, reported between 31±3%.

Purpose of the Study:

  • To evaluate the utility of strain imaging for early detection of LV dysfunction in patients undergoing RV apical pacing.
  • To identify factors associated with pacing-induced cardiomyopathy.

Main Methods:

  • Sixty subjects with high-grade atrioventricular block (AV block) and Complete Heart Block (CHB) underwent 2D echocardiography and strain imaging at baseline, 1 month, and 12 months.
  • Longitudinal strain (GLS) was measured using cardiac wall motion quantification (CMQ) software.
  • Pacing-induced cardiomyopathy was defined as LVEF <45%.

Main Results:

  • No baseline LV dysfunction was observed.
  • At 1 month, 18 patients showed a low GLS score (< -14.5).
  • By 1 year, all 18 patients with low GLS developed LV dysfunction on 2D echocardiography. Pacing-induced cardiomyopathy was associated with high-grade AV block and pacemaker dependency, and heart failure, but not other comorbidities.

Conclusions:

  • Strain imaging, specifically GLS, enables early detection of LV dysfunction in RV apical pacing patients.
  • Early identification facilitates management of pacing-induced cardiomyopathy, particularly in pacemaker-dependent individuals.