TY - JOUR
T1 - The influence of scar on the spatio-temporal relationship between electrical and mechanical activation in heart failure patients
AU - Maffessanti, Francesco
AU - Jadczyk, Tomasz
AU - Kurzelowski, Radoslaw
AU - Regoli, Francois
AU - Caputo, Maria Luce
AU - Conte, Giulio
AU - Golba, Krzysztof S.
AU - Biernat, Jolanta
AU - Wilczek, Jacek
AU - Dabrowska, Magdalena
AU - Pezzuto, Simone
AU - Moccetti, Tiziano
AU - Krause, Rolf
AU - Wojakowski, Wojciech
AU - Prinzen, Frits W.
AU - Auricchio, Angelo
N1 - Funding Information:
This work was in part supported by grants from the Swiss National Science Foundation under project 32003B_165802, from the Swiss Heart Foundation, and by a restricted grant of Biologic Delivery Systems, Division of Biosense Webster a Johnson & Johnson Company. Statutory funds of the Medical University of Silesia [KNW-1-135/N/6/K] and [POIG.01.01.02-00-109/09] grant to W.W.
Publisher Copyright:
© The Author(s) 2020.
PY - 2020/5
Y1 - 2020/5
N2 - 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 = 0.011 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].Conclusions Scar decreases the association between electrical and mechanical activation, even when scar is remote from late activated regions.
AB - 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 = 0.011 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].Conclusions Scar decreases the association between electrical and mechanical activation, even when scar is remote from late activated regions.
KW - Heart failure
KW - Cardiac resynchronization therapy
KW - Cardiac magnetic resonance
KW - Activation
KW - Left bundle branch block
KW - Scar
KW - CARDIAC-RESYNCHRONIZATION THERAPY
KW - VENTRICULAR LEAD PLACEMENT
KW - DEFIBRILLATOR
KW - INFARCTION
KW - MORTALITY
KW - IMPROVES
U2 - 10.1093/europace/euz346
DO - 10.1093/europace/euz346
M3 - Article
C2 - 31942982
SN - 1099-5129
VL - 22
SP - 777
EP - 786
JO - EP Europace
JF - EP Europace
IS - 5
ER -