Positron Emission Tomographic Demonstration of Myocardial Oxidative Metabolism in a Case of Left Ventricular Restoration After Cardiac Resynchronization Therapy

• Kitaizumi Kenji

  Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University

• Yukiiri Kazushi

  Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University

• Masugata Hisashi

  Department of Integrated Medicine, Kagawa University

• Shinomiya Kaori

  Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University

• Ohara Minako

  Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University

• Takinami Hiroyuki

  Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University

• Iwado Yasuyoshi

  Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University

• Yoshida Junji

  Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University

• Noma Takahisa

  Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University

• Ohmori Koji

  Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University

• Yamashita Yoichi

  Department of Cardiovascular Surgery, Kagawa University

• Horii Taiko

  Department of Cardiovascular Surgery, Kagawa University

• Senda Shoich

  Department of Integrated Medicine, Kagawa University

• Kohno Masakazu

  Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University

Abstract

A 65-year-old man with a history of coronary artery bypass grafting was admitted because of severe heart failure. Echocardiography showed diffuse severe hypokinesis of the left ventricle (ejection fraction 25%) and severe mitral regurgitation caused by tethering of the leaflet secondary to left ventricular (LV) dilation. He underwent mitral valve annuloplasty and LV papillary muscle imbrication, but postoperative sustained ventricular tachycardia developed and echocardiography showed ventricular dyssynchrony with a long septal-to-posterior wall motion delay (>130 ms). Cardiac resynchronization therapy (CRT) was performed using a biventricular pacing system with an implantable cardioverter defibrillator, but biventricular pacing prolonged the QRS duration from 130 to 160 ms, so ¹¹C-acetate positron emission tomography was performed to evaluate the CRT. During biventricular pacing, myocardial oxidative consumption decreased by 15% and cardiac efficiency increased by 33%. The plasma brain natriuretic peptide level, which was 9,500 pg/ml preoperatively, decreased to 173 pg/ml just before discharge from hospital. (Circ J 2008; 72: 1900 - 1903)<br>

Journal

• Circulation Journal

  Circulation Journal 72 (11), 1900-1903, 2008

  The Japanese Circulation Society

Keywords

• Cardiac resynchronization therapy
• Left ventricular papillary muscle imbrication
• Positron emission tomography

Details

• CRID: 1390001205104113152
• NII Article ID: 110006975586
• NII Book ID: AA11591968
• DOI: 10.1253/circj.cj-07-1011
• ISSN: 13474820
• ISSN: 13469843
• Web Site: http://www.jstage.jst.go.jp/article/circj/72/11/72_CJ-07-1011/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2009066178
• Text Lang: en
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
• Abstract License Flag: Disallowed