We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
The Effect of DDD Pacing on Ergospirometric Parameters and Neurohormonal Activity in Patients with Hypertrophic Obstructive Cardiomyopathy.
- Authors
Simantirakis, Emmanuel N.; Kanoupakis, Emmanuel M.; Kochiadakis, George E.; Kanakaraki, Marina K.; Parthenakis, Fragiskos I.; Manios, Emmanuel G.; Markianos, Emmanuel; Vardas, Panos E.
- Abstract
This study examined the acute and long-term effects of DDD pacing on ergospirometric parameters and neurohormonal activity in patients with hypertrophic obstructive cardiomyopathy (HOCM). We studied eight patients (five males), aged 56 ± 7 years, with HOCM refractory to drugs. In all patients a DDD pacemaker was implanted and programmed with an atrioventricular (AV) delay that insured full ventricular activation. The patients underwent echocardiographic examination and exercise stress testing before and 3 days, 3 months, and 12 months after pacemaker implantation. Oxygen consumption was measured at the anaerobic threshold (VO2AT) and peak exercise (pVO2). Atrial natriuretic peptide (ANP) and cyclic adenosine monophosphate (c-AMP) levels were measured concomitantly. Left ventricular outflow tract (LVOT) pressure gradient decreased significantly from 70 ± 18 to 25 ± 12 mmHg (P < 0.05) 3 days after pacing and remained unchanged at 3 and 12 months. pVO2 and VO2AT increased significantly, from 20.1 ± 3 to 23.4 ± 3 mL/kg/min and from 16 ± 3 to 17.8 ±2 mL/kg/min, respectively (P < 0.05). This improvement continued up to 3 months, and then remained stable until the end of the 12-month follow-up period. ANP levels decreased at 3 days from 85.4 ± 5.7 to 75.4 ± 7.3 fmol/mL (P < 0.05), and remained unchanged over the 12 months. c-AMP levels did not change significantly after the onset of pacing. DDD pacing in patients with HOCM not only reduces the LVOT pressure gradient but also causes a significant early and long-term improvement in exercise capacity and neurohormonal profile.
- Subjects
HYPERTROPHIC cardiomyopathy; CARDIAC pacemakers; CARDIAC pacing; HEART diseases; NEUROHORMONES; ECHOCARDIOGRAPHY
- Publication
Pacing & Clinical Electrophysiology, 1998, Vol 21, Issue 11, p2269
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/j.1540-8159.1998.tb01165.x