Cardiac sympathetic reserve and response to cardiac resynchronization therapy

Yong-Mei Cha, Panithaya Chareonthaitawee, Ying Xue Dong, Bradley J. Kemp, Jae Kuen Oh, Chinami Miyazaki, David L. Hayes, Robert F. Rea, Samuel J Asirvatham, Tracy L. Webster, Connie M. Dalzell, David O. Hodge, Regina M. Herges, Yan Zhong Yong, Yanhua Zhang, Peng Sheng Chen

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background-The objective of the present study was to investigate the effect of cardiac resynchronization therapy (CRT) on cardiac autonomic function. Methods and Results-This prospective study included 45 consecutive patients with heart failure who received CRT devices with defibrillator and 20 age-matched, healthy control subjects. At baseline and 3 months and 6 months after CRT, we assessed New York Heart Association (NYHA) class, 6-minute walk distance, plasma sympathetic biomarker nerve growth factor, echocardiography, heart rate variability and cardiac presynaptic sympathetic function determined by iodine 123 metaiodobenzylguanidine scintigraphy. After CRT, NYHA class improved by 1 class (P<0.001), and left ventricular ejection fraction increased by 8% (P<0.001). Along with improvement in the standard deviation of all normal-to-normal R-R intervals (85.63±31.66 ms versus 114.79±38.99 ms; P=0.004) and the standard deviation of the averaged normal-to-normal R-R intervals (82.62±23.03 ms versus 100.50±34.87 ms; P=0.004), the delayed heart/mediastinum (H/M) ratio increased (1.82 [0.58] versus 1.97 [0.59]; P-0.03), whereas the mean (SD) H/M washout rate was reduced (48% [19%] versus 37% [22%]; P=0.01). Twenty-two of 45 study patients responded to CRT, with a reduction of left ventricular end-systolic volume index >15%. Compared with nonresponders, responders had a higher delayed H/M ratio (2.11 versus 1.48; P=0.003) and lower H/M washout rate (37% versus 62%; P=0.003) at baseline. Conclusions-CRT improved sympathetic function. Cardiac sympathetic reserve may be a marker for the reversibility of failing myocardial function.

Original languageEnglish (US)
Pages (from-to)339-344
Number of pages6
JournalCirculation: Heart Failure
Volume4
Issue number3
DOIs
StatePublished - May 2011

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Cardiac Resynchronization Therapy
Cardiac Resynchronization Therapy Devices
Defibrillators
Nerve Growth Factor
Radionuclide Imaging
Iodine
Echocardiography
Healthy Volunteers
Heart Failure
Biomarkers
Heart Rate
Prospective Studies

Keywords

  • Cardiac resynchronization therapy
  • Heart failure
  • Metaiodobenzylguanidine iodine 123
  • Nerve growth factor
  • Sympathetic nerve

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

Cardiac sympathetic reserve and response to cardiac resynchronization therapy. / Cha, Yong-Mei; Chareonthaitawee, Panithaya; Dong, Ying Xue; Kemp, Bradley J.; Oh, Jae Kuen; Miyazaki, Chinami; Hayes, David L.; Rea, Robert F.; Asirvatham, Samuel J; Webster, Tracy L.; Dalzell, Connie M.; Hodge, David O.; Herges, Regina M.; Yong, Yan Zhong; Zhang, Yanhua; Chen, Peng Sheng.

In: Circulation: Heart Failure, Vol. 4, No. 3, 05.2011, p. 339-344.

Research output: Contribution to journalArticle

Cha, Y-M, Chareonthaitawee, P, Dong, YX, Kemp, BJ, Oh, JK, Miyazaki, C, Hayes, DL, Rea, RF, Asirvatham, SJ, Webster, TL, Dalzell, CM, Hodge, DO, Herges, RM, Yong, YZ, Zhang, Y & Chen, PS 2011, 'Cardiac sympathetic reserve and response to cardiac resynchronization therapy', Circulation: Heart Failure, vol. 4, no. 3, pp. 339-344. https://doi.org/10.1161/CIRCHEARTFAILURE.110.959858
Cha, Yong-Mei ; Chareonthaitawee, Panithaya ; Dong, Ying Xue ; Kemp, Bradley J. ; Oh, Jae Kuen ; Miyazaki, Chinami ; Hayes, David L. ; Rea, Robert F. ; Asirvatham, Samuel J ; Webster, Tracy L. ; Dalzell, Connie M. ; Hodge, David O. ; Herges, Regina M. ; Yong, Yan Zhong ; Zhang, Yanhua ; Chen, Peng Sheng. / Cardiac sympathetic reserve and response to cardiac resynchronization therapy. In: Circulation: Heart Failure. 2011 ; Vol. 4, No. 3. pp. 339-344.
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AU - Chareonthaitawee, Panithaya

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AU - Kemp, Bradley J.

AU - Oh, Jae Kuen

AU - Miyazaki, Chinami

AU - Hayes, David L.

AU - Rea, Robert F.

AU - Asirvatham, Samuel J

AU - Webster, Tracy L.

AU - Dalzell, Connie M.

AU - Hodge, David O.

AU - Herges, Regina M.

AU - Yong, Yan Zhong

AU - Zhang, Yanhua

AU - Chen, Peng Sheng

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N2 - Background-The objective of the present study was to investigate the effect of cardiac resynchronization therapy (CRT) on cardiac autonomic function. Methods and Results-This prospective study included 45 consecutive patients with heart failure who received CRT devices with defibrillator and 20 age-matched, healthy control subjects. At baseline and 3 months and 6 months after CRT, we assessed New York Heart Association (NYHA) class, 6-minute walk distance, plasma sympathetic biomarker nerve growth factor, echocardiography, heart rate variability and cardiac presynaptic sympathetic function determined by iodine 123 metaiodobenzylguanidine scintigraphy. After CRT, NYHA class improved by 1 class (P<0.001), and left ventricular ejection fraction increased by 8% (P<0.001). Along with improvement in the standard deviation of all normal-to-normal R-R intervals (85.63±31.66 ms versus 114.79±38.99 ms; P=0.004) and the standard deviation of the averaged normal-to-normal R-R intervals (82.62±23.03 ms versus 100.50±34.87 ms; P=0.004), the delayed heart/mediastinum (H/M) ratio increased (1.82 [0.58] versus 1.97 [0.59]; P-0.03), whereas the mean (SD) H/M washout rate was reduced (48% [19%] versus 37% [22%]; P=0.01). Twenty-two of 45 study patients responded to CRT, with a reduction of left ventricular end-systolic volume index >15%. Compared with nonresponders, responders had a higher delayed H/M ratio (2.11 versus 1.48; P=0.003) and lower H/M washout rate (37% versus 62%; P=0.003) at baseline. Conclusions-CRT improved sympathetic function. Cardiac sympathetic reserve may be a marker for the reversibility of failing myocardial function.

AB - Background-The objective of the present study was to investigate the effect of cardiac resynchronization therapy (CRT) on cardiac autonomic function. Methods and Results-This prospective study included 45 consecutive patients with heart failure who received CRT devices with defibrillator and 20 age-matched, healthy control subjects. At baseline and 3 months and 6 months after CRT, we assessed New York Heart Association (NYHA) class, 6-minute walk distance, plasma sympathetic biomarker nerve growth factor, echocardiography, heart rate variability and cardiac presynaptic sympathetic function determined by iodine 123 metaiodobenzylguanidine scintigraphy. After CRT, NYHA class improved by 1 class (P<0.001), and left ventricular ejection fraction increased by 8% (P<0.001). Along with improvement in the standard deviation of all normal-to-normal R-R intervals (85.63±31.66 ms versus 114.79±38.99 ms; P=0.004) and the standard deviation of the averaged normal-to-normal R-R intervals (82.62±23.03 ms versus 100.50±34.87 ms; P=0.004), the delayed heart/mediastinum (H/M) ratio increased (1.82 [0.58] versus 1.97 [0.59]; P-0.03), whereas the mean (SD) H/M washout rate was reduced (48% [19%] versus 37% [22%]; P=0.01). Twenty-two of 45 study patients responded to CRT, with a reduction of left ventricular end-systolic volume index >15%. Compared with nonresponders, responders had a higher delayed H/M ratio (2.11 versus 1.48; P=0.003) and lower H/M washout rate (37% versus 62%; P=0.003) at baseline. Conclusions-CRT improved sympathetic function. Cardiac sympathetic reserve may be a marker for the reversibility of failing myocardial function.

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KW - Nerve growth factor

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