TY - JOUR
T1 - Sustained sympathoinhibitory effects of cardiac resynchronization therapy in severe heart failure
AU - Grassi, Guido
AU - Vincenti, Antonio
AU - Brambilla, Roberta
AU - Trevano, Fosca Quarti
AU - Dell'Oro, Raffaella
AU - Cirò, Antonio
AU - Trocino, Giuseppe
AU - Vincenzi, Antonella
AU - Mancia, Giuseppe
PY - 2004/11
Y1 - 2004/11
N2 - Evidence is available that in heart failure, cardiac resynchronization therapy by biventricular pacing improves myocardial function and exercise capacity. Whether this is accompanied by a sustained inhibition of heart failure-dependent sympathoexcitation is uncertain. In 11 heart failure patients (mean±SEM age, 68.4±1.5 years) in New York Heart Association (NYHA) class III and IV under medical treatment with an intraventricular conduction delay (QRS duration ≥130 ms), with a markedly depressed left ventricular ejection fraction, and undergoing implantation of a biventricular pacemaker, we measured beat-to-beat blood pressure and muscle sympathetic nerve traffic. Measurements, which also included echocardiographic and clinical variables, were performed before and ≈10 weeks after successful resynchronization therapy. Ten age- and NYHA class-matched heart failure patients who were under medical treatment for the same time period served as controls. Long-term resynchronization therapy improved cardiac function and caused a significant increase in systolic blood pressure coupled with an improvement in maximal oxygen consumption and exercise capacity. These effects were coupled with a significant and marked reduction in sympathetic nerve traffic when expressed both as burst frequency over time (44.1±3.6 vs 30.7±3.0 bs/min, -30.5%, P
AB - Evidence is available that in heart failure, cardiac resynchronization therapy by biventricular pacing improves myocardial function and exercise capacity. Whether this is accompanied by a sustained inhibition of heart failure-dependent sympathoexcitation is uncertain. In 11 heart failure patients (mean±SEM age, 68.4±1.5 years) in New York Heart Association (NYHA) class III and IV under medical treatment with an intraventricular conduction delay (QRS duration ≥130 ms), with a markedly depressed left ventricular ejection fraction, and undergoing implantation of a biventricular pacemaker, we measured beat-to-beat blood pressure and muscle sympathetic nerve traffic. Measurements, which also included echocardiographic and clinical variables, were performed before and ≈10 weeks after successful resynchronization therapy. Ten age- and NYHA class-matched heart failure patients who were under medical treatment for the same time period served as controls. Long-term resynchronization therapy improved cardiac function and caused a significant increase in systolic blood pressure coupled with an improvement in maximal oxygen consumption and exercise capacity. These effects were coupled with a significant and marked reduction in sympathetic nerve traffic when expressed both as burst frequency over time (44.1±3.6 vs 30.7±3.0 bs/min, -30.5%, P
KW - Autonomic nervous system
KW - Electrical stimulation
KW - Heart failure
KW - Sympathetic nervous system
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U2 - 10.1161/01.HYP.0000144271.59333.a7
DO - 10.1161/01.HYP.0000144271.59333.a7
M3 - Article
C2 - 15381677
AN - SCOPUS:7244239085
VL - 44
SP - 727
EP - 731
JO - Hypertension
JF - Hypertension
SN - 0194-911X
IS - 5
ER -