Failing Left Ventricles Have an Enhanced Post-Stimulation Potentiation Despite Their Impaired Force Frequency Relationship
-
- Watanabe Tohru
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences
-
- Kashimura Takeshi
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences
-
- Kodama Makoto
- Kodama Clinic
-
- Tanaka Komei
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences
-
- Fujiki Shinya
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences
-
- Hayashi Yuka
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences
-
- Obata Hiroaki
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences
-
- Hanawa Haruo
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences
-
- Minamino Tohru
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences
この論文をさがす
抄録
The left ventricular contractile force (LV dP/dtmax) of patients with left ventricular systolic dysfunction does not increase effectively with an increase in heart rate. In other words, their force-frequency relationship (FFR) is impaired. However, it is unknown whether a longer coupling interval subsequent to tachycardia causes a stronger contraction (poststimulation potentiation, PSP) in a rate-dependent manner.<br>In 16 patients with idiopathic dilated cardiomyopathy (DCM) (48 ± 2 years old, LVEF 30 ± 10%) and 6 control patients (58 ± 4 years old, LVEF 70 ± 7%), FFR was assessed by right atrial pacing using a micro-manometer-tipped catheter. At each pacing rate, the increase of LV dP/dtmax over basal LV dP/dt (ΔFFR) and the increase of LV dP/dtmax of the first beat after pacing cessation over LV dP/dtmax during pacing (ΔPSP) were evaluated.<br>Patients with DCM had smaller LV dP/dtmax at baseline (872 ± 251 versus 1370 ± 123 mmHg/second, P = 0.0002) and developed smaller ΔFFR (eg, at 120/minute, 77 ± 143 versus 331 ± 131 mmHg/second, P = 0.0011). In contrast, they showed a rate-dependent increase of LV dP/dtmax of PSP and had greater ΔPSP (eg, at 120/minute, 294 ± 173 versus -152 ± 131 mmHg/second, P < 0.0001).<br>Failing left ventricles develop little contractile force during tachycardia despite their rate-dependent enhancement in post-stimulation potentiation, suggesting that refractoriness of contractile force underlies impaired FFR.
収録刊行物
-
- International Heart Journal
-
International Heart Journal 57 (3), 317-322, 2016
一般社団法人 インターナショナル・ハート・ジャーナル刊行会
