Pre-implant global longitudinal strain as an early sign of pacing-induced cardiomyopathy in patients with complete atrioventricular blockopen access
- Authors
- Chin, Jung Yeon; Kang, Ki-Woon; Park, Sang Hyun; Choi, Yu Jeong; Jung, Kyung Tae; Lee, Soyoung; Youn, Ho-Joong
- Issue Date
- Feb-2021
- Publisher
- WILEY
- Keywords
- cardiomyopathy; left ventricular function; myocardial strain
- Citation
- ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES, v.38, no.2, pp 175 - 182
- Pages
- 8
- Journal Title
- ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES
- Volume
- 38
- Number
- 2
- Start Page
- 175
- End Page
- 182
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/72440
- DOI
- 10.1111/echo.14942
- ISSN
- 0742-2822
1540-8175
- Abstract
- Introduction: Long-term right ventricular pacing is the only treatment for patients with a complete atrioventricular block (CAVB); however, it frequently triggers ventricular dys-synchrony with left ventricular (LV) dysfunction. Previous studies showed that an early decline of LV global longitudinal strain (GLS) predicts pacing-induced LV dysfunction. We aimed to investigate the potential ability of the initial LV strain to predict pacing-induced cardiomyopathy (PICM) through long-term follow-ups. Methods: We retrospectively enrolled 80 patients with CAVB with normal LV function who were implanted with dual-chamber pacemakers between 2008 and 2018. Echocardiographic data and parameters (including longitudinal, radial, and circumferential strain based on speckle-tracking) were analyzed for the pre-implant (<= 6 months) and post-implant periods. PICM was defined as a >= 10% reduction in the left ventricular ejection fraction (LVEF) resulting in an LVEF of Results: Patients who developed PICM were more likely to exhibit lower baseline LV GLS, as well as wider native and pacing QRS durations, than those who did not develop PICM (P = .016, P = .011, and P = .026, respectively). In the multivariate analysis, pre-implant LV GLS (hazard ratio: 1.27; 95% confidence interval 1.009-1.492; P = .004) was independently associated with the development of PICM. Conclusion: A lower baseline LV GLS predicts an increased risk of PICM. Patients with CAVB exhibiting low GLS are at increased risk of PICM. More frequent follow-up visits are warranted in these patients, who may also require de novo His-bundle pacing or an upgrade to biventricular pacing.
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