(Circulation. 2000;101:e2.)
© 2000 American Heart Association, Inc.
Circulation Electronic Pages |
From the Division of Cardiology, the Department of Medicine (C.W.C., G.S.N., M.T., R.D.B., D.A.K.), the Department of Biomedical Engineering (B.T.W., J.D., E.R.M., D.A.K.), and the Department of Radiology (E.R.M.), The Johns Hopkins Medical Institutions, Baltimore, Md.
Correspondence to David A. Kass, MD, Halsted 500, the Johns Hopkins Hospital, 600 N Wolfe Street, Baltimore, MD 21287. E-mail dkass{at}bme.jhu.edu
| Introduction |
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-20% by end-systole) across the wall. In
contrast, the contraction pattern is markedly dyssynchronous in the
heart with dilated cardiomyopathy.
Myocardium in the septal region (green dot denotes septum)
becomes first blue in early systole and then yellow (ie, stretching) in
late systole. Contraction slowly spreads to the lateral wall as the
septum develops positive strains. The temporal magnitude of
dyssynchrony is substantial. In this and other such patients,
ventricular free wall (or biventricular) pacing
with preexcitation1 2 3 4 enhances the systolic
function of the heart.
| Footnotes |
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Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Lukes Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.
| References |
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2.
Leclercq C, Cazeau S, Le Breton H, Ritter P, Mabo P,
Gras D, Pavin D, Lazarus A, Daubert JC. Acute
hemodynamic effects of biventricular DDD
pacing in patients with end-stage heart failure. J Am Coll
Cardiol. 1998;32:18251831.
3.
Kass DA, Chen C-H, Curry C, Talbot M, Berger R, Fetics
B, Nevo E. Improved left ventricular mechanics from acute
VDD pacing in patients with dilated cardiomyopathy
and ventricular conduction delay. Circulation. 1999;99:15671573.
4.
Auricchio A, Stellbrink C, Block M, Sack S, Vogt J,
Bakker P, Klein H, for the Pacing Therapies for Congestive Heart
Failure Study Group, Kramer A, Ding J, Salo R, Tockman B, Poochet T,
Spinelli J, for the Guidant Congestive Heart Failure Research Group.
Effect of pacing chamber and atrioventricular delay on
acute systolic function of paced patients with congestive heart
failure. Circulation. 1999;99:29933001.
5. McVeigh ER, Atalar E. Cardiac tagging with breath-hold cine MRI. Magn Reson Med. 1992;28:318327.[Medline] [Order article via Infotrieve]
6. McVeigh ER. Regional myocardial function. Cardiol Clin. 1998;16:189206.[Medline] [Order article via Infotrieve]
7. McVeigh ER, Prinzen FW, Wyman BT, Tsitlik JE, Halperin HR, Hunter WC. Imaging asynchronous mechanical activation of the paced heart with tagged MRI. Magn Reson Med. 1998;39:507513.[Medline] [Order article via Infotrieve]
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