RELATION OF THE LATE ACTIVATION ZONE WITH THE LEFT VENTRICLE MYOCARIDUM CHANGES IN CANDIDATES FOR RESYNCHRONIZING THERAPY

Aim. By non-invasive methods, to assess relations of the zone of late electrical activation with changes in the left ventricle (LV) myocardium structure in patients — candidates for cardiac resynchronizing therapy. Material and methods. Totally, 37 patients included, with III functional class of chr...

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Main Authors: S. V. Zubarev, M. P. Chmelevsky, M. A. Budanova, A. V. Ryzhkov, M. A. Trukshina, V. K. Lebedeva, M. Yu. Sitnikova, D. S. Lebedev
Format: Article
Language:Russian
Published: «FIRMA «SILICEA» LLC 2017-08-01
Series:Российский кардиологический журнал
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Online Access:https://russjcardiol.elpub.ru/jour/article/view/1667
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author S. V. Zubarev
M. P. Chmelevsky
M. A. Budanova
A. V. Ryzhkov
M. A. Trukshina
V. K. Lebedeva
M. Yu. Sitnikova
D. S. Lebedev
author_facet S. V. Zubarev
M. P. Chmelevsky
M. A. Budanova
A. V. Ryzhkov
M. A. Trukshina
V. K. Lebedeva
M. Yu. Sitnikova
D. S. Lebedev
author_sort S. V. Zubarev
collection DOAJ
description Aim. By non-invasive methods, to assess relations of the zone of late electrical activation with changes in the left ventricle (LV) myocardium structure in patients — candidates for cardiac resynchronizing therapy. Material and methods. Totally, 37 patients included, with III functional class of chronic heart failure (CHF). In all patients, there was complete His left bundle branch block (LBBB) with QRS width 205 (190; 215) ms. Non-invasive electrophysiological mapping (NEM) was done with the “Amycard01C EP LAB” (EP Solutions SA,Switzerland), and magnetic-resonance imaging (MRI). At the first step, multichannel electrocardiography (ECG) was done. At the second step, MRI was done (MAGNETOM Trio A Tim 3 T, Siemens AG,Germany) with intravenous contrast “Gadovist” load. Changes inLV myocardium structure (post-inflammatory fibrosis or scar tissue) were evaluated by segments, within the delayed MRI contrasting. At the third stage, individual models of ventricles were built up. Activation ofLV epicardium in LBBB was evaluated by NEM.Results. Most oftenly the zone of late activation by NEM was found in the basal region on the border of posterior and lateral LV segments — 17 patients (46%) and in basal lateral LV segment — 8 (21%). By MRI, only post inflammatory fibrosis was found in 21 patient, among them in 5 the area of fibrosis was located on LV epicardium and overlapped the zone of late activation by NEM. Among 12 patients with ischemic heart disease 2 had scar onLV epicardium overlapping with the late activation zone. No one of 4 patients with combination of post-inflammatory fibrosis and ischemic scar did not show overlap of structural changes on the epicardium with the late activation zone.Conclusion. Combination of NEM and MRI in pre-operational period of patients investigation make it to relate structural changes inLV myocardium with the zone of its late electrical activation.
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spelling doaj-art-df964fddd4c945b5b5b6e901e6a05a7a2025-08-20T03:43:34Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202017-08-0107939810.15829/1560-4071-2017-7-93-981441RELATION OF THE LATE ACTIVATION ZONE WITH THE LEFT VENTRICLE MYOCARIDUM CHANGES IN CANDIDATES FOR RESYNCHRONIZING THERAPYS. V. Zubarev0M. P. Chmelevsky1M. A. Budanova2A. V. Ryzhkov3M. A. Trukshina4V. K. Lebedeva5M. Yu. Sitnikova6D. S. Lebedev7Federal Almazov North-West Medical Research Centre of the Ministry of HealthFederal Almazov North-West Medical Research Centre of the Ministry of HealthFederal Almazov North-West Medical Research Centre of the Ministry of HealthFederal Almazov North-West Medical Research Centre of the Ministry of HealthFederal Almazov North-West Medical Research Centre of the Ministry of HealthFederal Almazov North-West Medical Research Centre of the Ministry of HealthFederal Almazov North-West Medical Research Centre of the Ministry of HealthFederal Almazov North-West Medical Research Centre of the Ministry of HealthAim. By non-invasive methods, to assess relations of the zone of late electrical activation with changes in the left ventricle (LV) myocardium structure in patients — candidates for cardiac resynchronizing therapy. Material and methods. Totally, 37 patients included, with III functional class of chronic heart failure (CHF). In all patients, there was complete His left bundle branch block (LBBB) with QRS width 205 (190; 215) ms. Non-invasive electrophysiological mapping (NEM) was done with the “Amycard01C EP LAB” (EP Solutions SA,Switzerland), and magnetic-resonance imaging (MRI). At the first step, multichannel electrocardiography (ECG) was done. At the second step, MRI was done (MAGNETOM Trio A Tim 3 T, Siemens AG,Germany) with intravenous contrast “Gadovist” load. Changes inLV myocardium structure (post-inflammatory fibrosis or scar tissue) were evaluated by segments, within the delayed MRI contrasting. At the third stage, individual models of ventricles were built up. Activation ofLV epicardium in LBBB was evaluated by NEM.Results. Most oftenly the zone of late activation by NEM was found in the basal region on the border of posterior and lateral LV segments — 17 patients (46%) and in basal lateral LV segment — 8 (21%). By MRI, only post inflammatory fibrosis was found in 21 patient, among them in 5 the area of fibrosis was located on LV epicardium and overlapped the zone of late activation by NEM. Among 12 patients with ischemic heart disease 2 had scar onLV epicardium overlapping with the late activation zone. No one of 4 patients with combination of post-inflammatory fibrosis and ischemic scar did not show overlap of structural changes on the epicardium with the late activation zone.Conclusion. Combination of NEM and MRI in pre-operational period of patients investigation make it to relate structural changes inLV myocardium with the zone of its late electrical activation.https://russjcardiol.elpub.ru/jour/article/view/1667left ventriclemagnetic-resonance imagingnon-invasive electrophysioilogical studycomplete his left bundle branch block
spellingShingle S. V. Zubarev
M. P. Chmelevsky
M. A. Budanova
A. V. Ryzhkov
M. A. Trukshina
V. K. Lebedeva
M. Yu. Sitnikova
D. S. Lebedev
RELATION OF THE LATE ACTIVATION ZONE WITH THE LEFT VENTRICLE MYOCARIDUM CHANGES IN CANDIDATES FOR RESYNCHRONIZING THERAPY
Российский кардиологический журнал
left ventricle
magnetic-resonance imaging
non-invasive electrophysioilogical study
complete his left bundle branch block
title RELATION OF THE LATE ACTIVATION ZONE WITH THE LEFT VENTRICLE MYOCARIDUM CHANGES IN CANDIDATES FOR RESYNCHRONIZING THERAPY
title_full RELATION OF THE LATE ACTIVATION ZONE WITH THE LEFT VENTRICLE MYOCARIDUM CHANGES IN CANDIDATES FOR RESYNCHRONIZING THERAPY
title_fullStr RELATION OF THE LATE ACTIVATION ZONE WITH THE LEFT VENTRICLE MYOCARIDUM CHANGES IN CANDIDATES FOR RESYNCHRONIZING THERAPY
title_full_unstemmed RELATION OF THE LATE ACTIVATION ZONE WITH THE LEFT VENTRICLE MYOCARIDUM CHANGES IN CANDIDATES FOR RESYNCHRONIZING THERAPY
title_short RELATION OF THE LATE ACTIVATION ZONE WITH THE LEFT VENTRICLE MYOCARIDUM CHANGES IN CANDIDATES FOR RESYNCHRONIZING THERAPY
title_sort relation of the late activation zone with the left ventricle myocaridum changes in candidates for resynchronizing therapy
topic left ventricle
magnetic-resonance imaging
non-invasive electrophysioilogical study
complete his left bundle branch block
url https://russjcardiol.elpub.ru/jour/article/view/1667
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