Reduction of left ventricular global longitudinal strain in patients with permanent pacemakers as a predictor of heart failure and mortality outcomes

被引：0

作者：

Manocha, Kevin ^{[1
]}

Kandola, Manjinder S. ^{[1
]}

Kalil, Ramsey ^{[1
]}

Sciria, Christopher ^{[1
]}

Bassil, Guillaume ^{[1
]}

Patel, Nishi ^{[1
]}

Lerman, Bruce B. ^{[1
]}

Kim, Jiwon ^{[1
]}

Abdelrahman, Mohamed ^{[1
]}

Cheung, Jim W. ^{[1
,2
]}

机构：

[1] New York Presbyterian Hosp, Dept Med, Div Cardiol, Weill Cornell Med, New York, NY USA

[2] Weill Cornell Med, Div Cardiol, 520 East 70th St,Starr 4, New York, NY 10021 USA

来源：

PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY | 2023年 / 46卷 / 05期

关键词：

heart failure; left ventricular global longitudinal strain; pacemaker; pacing-induced cardiomyopathy; right ventricular pacing; SYSTOLIC FUNCTION; ECHOCARDIOGRAPHY; CARDIOTOXICITY; ASSOCIATION; THERAPY; BLOCK;

D O I：

10.1111/pace.14701

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

IntroductionFrequent right ventricular (RV) pacing is associated with cardiomyopathy. The impact of RV pacing on left ventricular (LV) global longitudinal strain (GLS) and clinical outcomes is unclear. MethodsWe analyzed GLS via two-dimensional speckle tracking and LV ejection fraction (EF) on pre- and post-implantation transthoracic echocardiograms of patients undergoing dual chamber pacemaker implantation. We collected long-term data on strain, LVEF, and clinical outcomes. ResultsOne hundred and ten patients (mean age 76 +/- 12 years; 59 [54%] female) were followed for mean 23 +/- 17 months. Mean baseline LVEF was 58 +/- 11% and mean GLS was -17 +/- 4%. Twenty-four (22%) patients had an absolute decrease in LVEF > 10% and 43 (39%) patients had a relative reduction of GLS > 15%. Among patients with a reduction of GLS, a larger proportion of patients had RV pacing burden >= 20% (67% vs. 46%; p = .048). Compared to patients without GLS reduction, more patients with a reduction in GLS reached a composite endpoint of HF hospitalization, CRT upgrade or death (47% vs. 16%; p = .001). ConclusionReduction in LV GLS was seen in nearly four in 10 patients undergoing pacemaker implantation and was significantly associated with increased RV pacing burden. LV GLS reduction was associated with increased risk of adverse outcomes. LV GLS may have utility in predicting outcomes among patients with RV pacing.

引用

页码：385 / 391

页数：7