Myocardial stretch in early systole is a key determinant of the synchrony of left ventricular mechanical activity in vivo

Giuseppe Caracciolo, Georg Goliasch, Makoto Amaki, Manish Bansal, Ayumi Nakabo, Haruhiko Abe, Luis Scott, Luka Lipar, Gianni Pedrizzetti, Jagat Narula, Partho P. Sengupta

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Recent in-vitro observations suggest that left ventricular (LV) contraction is powered by 'stretch activation', an intrinsic mechanism by which the stretching of an activated cardiomyocyte causes delayed force redevelopment. We hypothesized that mechanical dyssynchrony is related to prolonged early systolic stretch that delays the timing of peak segmental shortening. Methods and Results: The time intervals from R wave to segmental longitudinal stretch in early systole (Tstretch) and peak shortening (Tpeak) and the respective standard deviations (σTstretch and σTpeak) were measured by speckle-tracking echocardiography in 57 patients undergoing cardiac resynchronization therapy (CRT). The percentage of time spent in shortening, normalized to Tpeak duration [corrected δT=(Tpeak-Tstretch)/Tpeak] correlated with LV reverse remodeling (reduction in end-systolic volume ≥15%). Of the 57 patients, 40 (70.2%) demonstrated LV reverse remodeling at an average follow-up of 263±125 days after CRT. At baseline, Tstretch and σTstretch correlated with Tpeak and σTpeak, respectively. Though there was no difference in Tstretch, Tpeak, σTstretch and σTpeak between responders and non-responders, corrected ΔT in the mid-lateral and mid-septal segments was shorter in the responders (P<0.05 for both) and the average of the 2 independently predicted LV reverse remodeling (area under the curve: 0.77, P=0.001). Conclusions: Mapping LV segmental shortening in relation to early systolic stretch may aid dyssynchrony assessment in patients undergoing CRT.

Original languageEnglish (US)
Pages (from-to)2526-2534
Number of pages9
JournalCirculation Journal
Volume77
Issue number10
DOIs
StatePublished - Oct 1 2013

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Cardiac Resynchronization Therapy
Ventricular Remodeling
Systole
Cardiac Myocytes
Area Under Curve
Echocardiography

Keywords

  • Cardiac resynchronization therapy
  • Heart failure
  • Left ventricular function

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Caracciolo, G., Goliasch, G., Amaki, M., Bansal, M., Nakabo, A., Abe, H., ... Sengupta, P. P. (2013). Myocardial stretch in early systole is a key determinant of the synchrony of left ventricular mechanical activity in vivo. Circulation Journal, 77(10), 2526-2534. https://doi.org/10.1253/circj.CJ-12-1230

Myocardial stretch in early systole is a key determinant of the synchrony of left ventricular mechanical activity in vivo. / Caracciolo, Giuseppe; Goliasch, Georg; Amaki, Makoto; Bansal, Manish; Nakabo, Ayumi; Abe, Haruhiko; Scott, Luis; Lipar, Luka; Pedrizzetti, Gianni; Narula, Jagat; Sengupta, Partho P.

In: Circulation Journal, Vol. 77, No. 10, 01.10.2013, p. 2526-2534.

Research output: Contribution to journalArticle

Caracciolo, G, Goliasch, G, Amaki, M, Bansal, M, Nakabo, A, Abe, H, Scott, L, Lipar, L, Pedrizzetti, G, Narula, J & Sengupta, PP 2013, 'Myocardial stretch in early systole is a key determinant of the synchrony of left ventricular mechanical activity in vivo', Circulation Journal, vol. 77, no. 10, pp. 2526-2534. https://doi.org/10.1253/circj.CJ-12-1230
Caracciolo, Giuseppe ; Goliasch, Georg ; Amaki, Makoto ; Bansal, Manish ; Nakabo, Ayumi ; Abe, Haruhiko ; Scott, Luis ; Lipar, Luka ; Pedrizzetti, Gianni ; Narula, Jagat ; Sengupta, Partho P. / Myocardial stretch in early systole is a key determinant of the synchrony of left ventricular mechanical activity in vivo. In: Circulation Journal. 2013 ; Vol. 77, No. 10. pp. 2526-2534.
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AU - Goliasch, Georg

AU - Amaki, Makoto

AU - Bansal, Manish

AU - Nakabo, Ayumi

AU - Abe, Haruhiko

AU - Scott, Luis

AU - Lipar, Luka

AU - Pedrizzetti, Gianni

AU - Narula, Jagat

AU - Sengupta, Partho P.

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N2 - Background: Recent in-vitro observations suggest that left ventricular (LV) contraction is powered by 'stretch activation', an intrinsic mechanism by which the stretching of an activated cardiomyocyte causes delayed force redevelopment. We hypothesized that mechanical dyssynchrony is related to prolonged early systolic stretch that delays the timing of peak segmental shortening. Methods and Results: The time intervals from R wave to segmental longitudinal stretch in early systole (Tstretch) and peak shortening (Tpeak) and the respective standard deviations (σTstretch and σTpeak) were measured by speckle-tracking echocardiography in 57 patients undergoing cardiac resynchronization therapy (CRT). The percentage of time spent in shortening, normalized to Tpeak duration [corrected δT=(Tpeak-Tstretch)/Tpeak] correlated with LV reverse remodeling (reduction in end-systolic volume ≥15%). Of the 57 patients, 40 (70.2%) demonstrated LV reverse remodeling at an average follow-up of 263±125 days after CRT. At baseline, Tstretch and σTstretch correlated with Tpeak and σTpeak, respectively. Though there was no difference in Tstretch, Tpeak, σTstretch and σTpeak between responders and non-responders, corrected ΔT in the mid-lateral and mid-septal segments was shorter in the responders (P<0.05 for both) and the average of the 2 independently predicted LV reverse remodeling (area under the curve: 0.77, P=0.001). Conclusions: Mapping LV segmental shortening in relation to early systolic stretch may aid dyssynchrony assessment in patients undergoing CRT.

AB - Background: Recent in-vitro observations suggest that left ventricular (LV) contraction is powered by 'stretch activation', an intrinsic mechanism by which the stretching of an activated cardiomyocyte causes delayed force redevelopment. We hypothesized that mechanical dyssynchrony is related to prolonged early systolic stretch that delays the timing of peak segmental shortening. Methods and Results: The time intervals from R wave to segmental longitudinal stretch in early systole (Tstretch) and peak shortening (Tpeak) and the respective standard deviations (σTstretch and σTpeak) were measured by speckle-tracking echocardiography in 57 patients undergoing cardiac resynchronization therapy (CRT). The percentage of time spent in shortening, normalized to Tpeak duration [corrected δT=(Tpeak-Tstretch)/Tpeak] correlated with LV reverse remodeling (reduction in end-systolic volume ≥15%). Of the 57 patients, 40 (70.2%) demonstrated LV reverse remodeling at an average follow-up of 263±125 days after CRT. At baseline, Tstretch and σTstretch correlated with Tpeak and σTpeak, respectively. Though there was no difference in Tstretch, Tpeak, σTstretch and σTpeak between responders and non-responders, corrected ΔT in the mid-lateral and mid-septal segments was shorter in the responders (P<0.05 for both) and the average of the 2 independently predicted LV reverse remodeling (area under the curve: 0.77, P=0.001). Conclusions: Mapping LV segmental shortening in relation to early systolic stretch may aid dyssynchrony assessment in patients undergoing CRT.

KW - Cardiac resynchronization therapy

KW - Heart failure

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