Biventricular pacemaker therapy improves exercise capacity in patients with non-obstructive hypertrophic cardiomyopathy via augmented diastolic filling on exercise

Research output: Contribution to journal › Article › peer-review

Standard

Biventricular pacemaker therapy improves exercise capacity in patients with non-obstructive hypertrophic cardiomyopathy via augmented diastolic filling on exercise. / Ahmed, Ibrar; Loudon, Brodie L; Abozguia, Khalid; Cameron, Donnie; Shivu, Ganesh N; Phan, Thanh T; Maher, Abdul; Stegemann, Berthold; Chow, Anthony; Marshall, Howard; Nightingale, Peter; Leyva, Francisco; Vassiliou, Vassilios S; McKenna, William J; Elliott, Perry; Frenneaux, Michael P.

In: European Journal of Heart Failure, 23.01.2020.

Research output: Contribution to journal › Article › peer-review

Harvard

Ahmed, I, Loudon, BL, Abozguia, K, Cameron, D, Shivu, GN, Phan, TT, Maher, A, Stegemann, B, Chow, A, Marshall, H, Nightingale, P, Leyva, F, Vassiliou, VS, McKenna, WJ, Elliott, P & Frenneaux, MP 2020, 'Biventricular pacemaker therapy improves exercise capacity in patients with non-obstructive hypertrophic cardiomyopathy via augmented diastolic filling on exercise', European Journal of Heart Failure. https://doi.org/10.1002/ejhf.1722

APA

Ahmed, I., Loudon, B. L., Abozguia, K., Cameron, D., Shivu, G. N., Phan, T. T., Maher, A., Stegemann, B., Chow, A., Marshall, H., Nightingale, P., Leyva, F., Vassiliou, V. S., McKenna, W. J., Elliott, P., & Frenneaux, M. P. (2020). Biventricular pacemaker therapy improves exercise capacity in patients with non-obstructive hypertrophic cardiomyopathy via augmented diastolic filling on exercise. European Journal of Heart Failure. https://doi.org/10.1002/ejhf.1722

Vancouver

Ahmed I, Loudon BL, Abozguia K, Cameron D, Shivu GN, Phan TT et al. Biventricular pacemaker therapy improves exercise capacity in patients with non-obstructive hypertrophic cardiomyopathy via augmented diastolic filling on exercise. European Journal of Heart Failure. 2020 Jan 23. https://doi.org/10.1002/ejhf.1722

Author

Ahmed, Ibrar ; Loudon, Brodie L ; Abozguia, Khalid ; Cameron, Donnie ; Shivu, Ganesh N ; Phan, Thanh T ; Maher, Abdul ; Stegemann, Berthold ; Chow, Anthony ; Marshall, Howard ; Nightingale, Peter ; Leyva, Francisco ; Vassiliou, Vassilios S ; McKenna, William J ; Elliott, Perry ; Frenneaux, Michael P. / Biventricular pacemaker therapy improves exercise capacity in patients with non-obstructive hypertrophic cardiomyopathy via augmented diastolic filling on exercise. In: European Journal of Heart Failure. 2020.

Bibtex

@article{dfbe514df4804d52b20ee064bd6c247b,
title = "Biventricular pacemaker therapy improves exercise capacity in patients with non-obstructive hypertrophic cardiomyopathy via augmented diastolic filling on exercise",
abstract = "AIMS: Treatment options for patients with non-obstructive hypertrophic cardiomyopathy (HCM) are limited. We sought to determine whether biventricular (BiV) pacing improves exercise capacity in HCM patients, and whether this is via augmented diastolic filling.METHODS AND RESULTS: Thirty-one patients with symptomatic non-obstructive HCM were enrolled. Following device implantation, patients underwent detailed assessment of exercise diastolic filling using radionuclide ventriculography in BiV and sham pacing modes. Patients then entered an 8-month crossover study of BiV and sham pacing in random order, to assess the effect on exercise capacity [peak oxygen consumption (VO2 )]. Patients were grouped on pre-specified analysis according to whether left ventricular end-diastolic volume increased (+LVEDV) or was unchanged/decreased (-LVEDV) with exercise at baseline. Twenty-nine patients (20 male, mean age 55 years) completed the study. There were 14 +LVEDV patients and 15 -LVEDV patients. Baseline peak VO2 was lower in -LVEDV patients vs. +LVEDV patients (16.2 ± 0.9 vs. 19.9 ± 1.1 mL/kg/min, P = 0.04). BiV pacing significantly increased exercise ΔLVEDV (P = 0.004) and Δstroke volume (P = 0.008) in -LVEDV patients, but not in +LVEDV patients. Left ventricular ejection fraction and end-systolic elastance did not increase with BiV pacing in either group. This translated into significantly greater improvements in exercise capacity (peak VO2  + 1.4 mL/kg/min, P = 0.03) and quality of life scores (P = 0.02) in -LVEDV patients during the crossover study. There was no effect on left ventricular mechanical dyssynchrony in either group.CONCLUSION: Symptomatic patients with non-obstructive HCM may benefit from BiV pacing via augmentation of diastolic filling on exercise rather than contractile improvement. This may be due to relief of diastolic ventricular interaction.CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT00504647.",
keywords = "Hypertrophic cardiomyopathy, Biventricular pacemaker therapy, Diastolic ventricular interaction",
author = "Ibrar Ahmed and Loudon, {Brodie L} and Khalid Abozguia and Donnie Cameron and Shivu, {Ganesh N} and Phan, {Thanh T} and Abdul Maher and Berthold Stegemann and Anthony Chow and Howard Marshall and Peter Nightingale and Francisco Leyva and Vassiliou, {Vassilios S} and McKenna, {William J} and Perry Elliott and Frenneaux, {Michael P}",
note = "{\textcopyright} 2020 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.",
year = "2020",
month = jan,
day = "23",
doi = "10.1002/ejhf.1722",
language = "English",
journal = "European Journal of Heart Failure",
issn = "1388-9842",
publisher = "Oxford University Press",

}

RIS

TY - JOUR

T1 - Biventricular pacemaker therapy improves exercise capacity in patients with non-obstructive hypertrophic cardiomyopathy via augmented diastolic filling on exercise

AU - Ahmed, Ibrar

AU - Loudon, Brodie L

AU - Abozguia, Khalid

AU - Cameron, Donnie

AU - Shivu, Ganesh N

AU - Phan, Thanh T

AU - Maher, Abdul

AU - Stegemann, Berthold

AU - Chow, Anthony

AU - Marshall, Howard

AU - Nightingale, Peter

AU - Leyva, Francisco

AU - Vassiliou, Vassilios S

AU - McKenna, William J

AU - Elliott, Perry

AU - Frenneaux, Michael P

N1 - © 2020 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

PY - 2020/1/23

Y1 - 2020/1/23

N2 - AIMS: Treatment options for patients with non-obstructive hypertrophic cardiomyopathy (HCM) are limited. We sought to determine whether biventricular (BiV) pacing improves exercise capacity in HCM patients, and whether this is via augmented diastolic filling.METHODS AND RESULTS: Thirty-one patients with symptomatic non-obstructive HCM were enrolled. Following device implantation, patients underwent detailed assessment of exercise diastolic filling using radionuclide ventriculography in BiV and sham pacing modes. Patients then entered an 8-month crossover study of BiV and sham pacing in random order, to assess the effect on exercise capacity [peak oxygen consumption (VO2 )]. Patients were grouped on pre-specified analysis according to whether left ventricular end-diastolic volume increased (+LVEDV) or was unchanged/decreased (-LVEDV) with exercise at baseline. Twenty-nine patients (20 male, mean age 55 years) completed the study. There were 14 +LVEDV patients and 15 -LVEDV patients. Baseline peak VO2 was lower in -LVEDV patients vs. +LVEDV patients (16.2 ± 0.9 vs. 19.9 ± 1.1 mL/kg/min, P = 0.04). BiV pacing significantly increased exercise ΔLVEDV (P = 0.004) and Δstroke volume (P = 0.008) in -LVEDV patients, but not in +LVEDV patients. Left ventricular ejection fraction and end-systolic elastance did not increase with BiV pacing in either group. This translated into significantly greater improvements in exercise capacity (peak VO2  + 1.4 mL/kg/min, P = 0.03) and quality of life scores (P = 0.02) in -LVEDV patients during the crossover study. There was no effect on left ventricular mechanical dyssynchrony in either group.CONCLUSION: Symptomatic patients with non-obstructive HCM may benefit from BiV pacing via augmentation of diastolic filling on exercise rather than contractile improvement. This may be due to relief of diastolic ventricular interaction.CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT00504647.

AB - AIMS: Treatment options for patients with non-obstructive hypertrophic cardiomyopathy (HCM) are limited. We sought to determine whether biventricular (BiV) pacing improves exercise capacity in HCM patients, and whether this is via augmented diastolic filling.METHODS AND RESULTS: Thirty-one patients with symptomatic non-obstructive HCM were enrolled. Following device implantation, patients underwent detailed assessment of exercise diastolic filling using radionuclide ventriculography in BiV and sham pacing modes. Patients then entered an 8-month crossover study of BiV and sham pacing in random order, to assess the effect on exercise capacity [peak oxygen consumption (VO2 )]. Patients were grouped on pre-specified analysis according to whether left ventricular end-diastolic volume increased (+LVEDV) or was unchanged/decreased (-LVEDV) with exercise at baseline. Twenty-nine patients (20 male, mean age 55 years) completed the study. There were 14 +LVEDV patients and 15 -LVEDV patients. Baseline peak VO2 was lower in -LVEDV patients vs. +LVEDV patients (16.2 ± 0.9 vs. 19.9 ± 1.1 mL/kg/min, P = 0.04). BiV pacing significantly increased exercise ΔLVEDV (P = 0.004) and Δstroke volume (P = 0.008) in -LVEDV patients, but not in +LVEDV patients. Left ventricular ejection fraction and end-systolic elastance did not increase with BiV pacing in either group. This translated into significantly greater improvements in exercise capacity (peak VO2  + 1.4 mL/kg/min, P = 0.03) and quality of life scores (P = 0.02) in -LVEDV patients during the crossover study. There was no effect on left ventricular mechanical dyssynchrony in either group.CONCLUSION: Symptomatic patients with non-obstructive HCM may benefit from BiV pacing via augmentation of diastolic filling on exercise rather than contractile improvement. This may be due to relief of diastolic ventricular interaction.CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT00504647.

KW - Hypertrophic cardiomyopathy

KW - Biventricular pacemaker therapy

KW - Diastolic ventricular interaction

U2 - 10.1002/ejhf.1722

DO - 10.1002/ejhf.1722

M3 - Article

C2 - 31975494

JO - European Journal of Heart Failure

JF - European Journal of Heart Failure

SN - 1388-9842

ER -