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Description
| - Background-Left ventricular (LV) dyssynchrony may occur as a result of right ventricular (RV) pacing and is a known risk factor for the development of heart failure. In children with complete atrioventricular block, pacing-induced dyssynchrony lasting for decades might be especially deleterious for LV function. To determine the hemodynamic and ultrastructural remodeling after either RV free wall or LV apical pacing, we used a chronic minipig model. Methods and Results-Fourteen piglets 8 weeks of age underwent atrioventricular node ablation and were paced from either the RV free wall or the LV apex at 120 bpm for 1 year (7 age-matched minipigs served as controls with spontaneous heart rates of 104 +/- 5 bpm). Echocardiographic examinations, pressure-volume loops, patch-clamp investigations, and examinations of connexin43, calcium-handling proteins, and histomorphology were carried out. RV free wall-paced minipigs exhibited significantly more LV dyssynchrony than LV apex-paced animals, which was accompanied by worsening of LV function (maximum LV mechanical delay/LV ejection fraction: RV free wall pacing, 154 +/- 36 ms/28 +/- 3%, LV apical pacing, 52 +/- 19 ms/45 +/- 2%, control 47 +/- 14 ms/62 +/- 1%; P = 0.0001). At the cellular level, both pacemaker groups exhibited a significant reduction in L-type calcium and peak sodium current, shortening of action potential duration and amplitude, increased cell capacity, and alterations in the calcium-handling proteins that were similar for RV free wall-and LV apex-paced animals. Conclusions-The observed molecular remodeling seemed to be more dependent on heart rate than on dyssynchrony. LV apical pacing is associated with less dyssynchrony, a more physiological LV contraction pattern, and preserved LV function as opposed to RV free wall pacing.
- Background-Left ventricular (LV) dyssynchrony may occur as a result of right ventricular (RV) pacing and is a known risk factor for the development of heart failure. In children with complete atrioventricular block, pacing-induced dyssynchrony lasting for decades might be especially deleterious for LV function. To determine the hemodynamic and ultrastructural remodeling after either RV free wall or LV apical pacing, we used a chronic minipig model. Methods and Results-Fourteen piglets 8 weeks of age underwent atrioventricular node ablation and were paced from either the RV free wall or the LV apex at 120 bpm for 1 year (7 age-matched minipigs served as controls with spontaneous heart rates of 104 +/- 5 bpm). Echocardiographic examinations, pressure-volume loops, patch-clamp investigations, and examinations of connexin43, calcium-handling proteins, and histomorphology were carried out. RV free wall-paced minipigs exhibited significantly more LV dyssynchrony than LV apex-paced animals, which was accompanied by worsening of LV function (maximum LV mechanical delay/LV ejection fraction: RV free wall pacing, 154 +/- 36 ms/28 +/- 3%, LV apical pacing, 52 +/- 19 ms/45 +/- 2%, control 47 +/- 14 ms/62 +/- 1%; P = 0.0001). At the cellular level, both pacemaker groups exhibited a significant reduction in L-type calcium and peak sodium current, shortening of action potential duration and amplitude, increased cell capacity, and alterations in the calcium-handling proteins that were similar for RV free wall-and LV apex-paced animals. Conclusions-The observed molecular remodeling seemed to be more dependent on heart rate than on dyssynchrony. LV apical pacing is associated with less dyssynchrony, a more physiological LV contraction pattern, and preserved LV function as opposed to RV free wall pacing. (en)
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Title
| - Right or Left Ventricular Pacing in Young Minipigs With Chronic Atrioventricular Block Long-Term In Vivo Cardiac Performance, Morphology, Electrophysiology, and Cellular Biology
- Right or Left Ventricular Pacing in Young Minipigs With Chronic Atrioventricular Block Long-Term In Vivo Cardiac Performance, Morphology, Electrophysiology, and Cellular Biology (en)
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skos:prefLabel
| - Right or Left Ventricular Pacing in Young Minipigs With Chronic Atrioventricular Block Long-Term In Vivo Cardiac Performance, Morphology, Electrophysiology, and Cellular Biology
- Right or Left Ventricular Pacing in Young Minipigs With Chronic Atrioventricular Block Long-Term In Vivo Cardiac Performance, Morphology, Electrophysiology, and Cellular Biology (en)
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skos:notation
| - RIV/00064203:_____/12:8192!RIV13-MZ0-00064203
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http://linked.open...avai/riv/aktivita
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http://linked.open...avai/riv/aktivity
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http://linked.open...iv/cisloPeriodika
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http://linked.open...vai/riv/dodaniDat
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http://linked.open...aciTvurceVysledku
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http://linked.open.../riv/druhVysledku
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http://linked.open...iv/duvernostUdaju
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http://linked.open...titaPredkladatele
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http://linked.open...dnocenehoVysledku
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http://linked.open...ai/riv/idVysledku
| - RIV/00064203:_____/12:8192
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http://linked.open...riv/jazykVysledku
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http://linked.open.../riv/klicovaSlova
| - cardiac pacing, artificial; myocardial contraction; pediatrics; ventricular remodeling; heart-failure; resynchronization therapy; gene-expression; dual-chamber; single-site; children; model; cardiomyopathy; dysfunction; mechanisms (en)
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http://linked.open.../riv/klicoveSlovo
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http://linked.open...odStatuVydavatele
| - US - Spojené státy americké
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http://linked.open...ontrolniKodProRIV
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http://linked.open...i/riv/nazevZdroje
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http://linked.open...in/vavai/riv/obor
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http://linked.open...ichTvurcuVysledku
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http://linked.open...cetTvurcuVysledku
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http://linked.open...vavai/riv/projekt
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http://linked.open...UplatneniVysledku
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http://linked.open...v/svazekPeriodika
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http://linked.open...iv/tvurceVysledku
| - Janoušek, Jan
- Blanke, K.
- Dahnert, I.
- Dhein, S.
- Dietze, A.
- Hiyasat, B.
- Rastan, A.
- Salameh, A.
- Sobiraij, A.
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http://linked.open...ain/vavai/riv/wos
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number of pages
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