1. The influence of scar on the spatio-temporal relationship between electrical and mechanical activation in heart failure patients
- Author
-
Tomasz Jadczyk, Radoslaw Kurzelowski, François Regoli, Jolanta Biernat, Maria Luce Caputo, Krzysztof S. Gołba, Magdalena Dąbrowska, Tiziano Moccetti, Angelo Auricchio, Wojciech Wojakowski, Francesco Maffessanti, Simone Pezzuto, Frits W. Prinzen, Rolf Krause, Jacek Wilczek, Giulio Conte, University of Zurich, Fysiologie, RS: Carim - H06 Electro mechanics, and Clinical sciences
- Subjects
medicine.medical_specialty ,VENTRICULAR LEAD PLACEMENT ,Cardiac magnetic resonance ,medicine.medical_treatment ,Heart Ventricles ,Area strain ,Cardiac resynchronization therapy ,Infarction ,Magnetic Resonance Imaging, Cine ,Activation ,610 Medicine & health ,Heart failure ,Heart Ventricles/diagnostic imaging ,030204 cardiovascular system & hematology ,11171 Cardiocentro Ticino ,2705 Cardiology and Cardiovascular Medicine ,03 medical and health sciences ,Cicatrix ,0302 clinical medicine ,2737 Physiology (medical) ,Scar ,Physiology (medical) ,Internal medicine ,medicine ,Electromechanical coupling ,IMPROVES ,Humans ,030212 general & internal medicine ,Endocardium ,CARDIAC-RESYNCHRONIZATION THERAPY ,medicine.diagnostic_test ,Left bundle branch block ,business.industry ,MORTALITY ,Magnetic resonance imaging ,medicine.disease ,Cicatrix/diagnostic imaging ,Heart Failure/diagnostic imaging ,DEFIBRILLATOR ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,INFARCTION - Abstract
Aims The aim of this study was to determine the relationship between electrical and mechanical activation in heart failure (HF) patients and whether electromechanical coupling is affected by scar. Methods and results Seventy HF patients referred for cardiac resynchronization therapy or biological therapy underwent endocardial anatomo-electromechanical mapping (AEMM) and delayed-enhancement magnetic resonance (CMR) scans. Area strain and activation times were derived from AEMM data, allowing to correlate mechanical and electrical activation in time and space with unprecedented accuracy. Special attention was paid to the effect of presence of CMR-evidenced scar. Patients were divided into a scar (n = 43) and a non-scar group (n–27). Correlation between time of electrical and mechanical activation was stronger in the non-scar compared to the scar group [R = 0.84 (0.72–0.89) vs. 0.74 (0.52–0.88), respectively; P = 0.01]. The overlap between latest electrical and mechanical activation areas was larger in the absence than in presence of scar [72% (54–81) vs. 56% (36–73), respectively; P = 0.02], with smaller distance between the centroids of the two regions [10.7 (4.9–17.4) vs. 20.3 (6.9–29.4) % of left ventricular radius, P = 0.02]. Conclusion Scar decreases the association between electrical and mechanical activation, even when scar is remote from late activated regions.
- Published
- 2020