Key result
Right ventricular septal permanent pacemaker implantation was associated with decreased miR-155 and increased IL-6, sTNFR-2, MMP-9, N-Cad, and ZO-1 levels in patients developing left ventricular dysfunction.
Why the study?
PPM implantation increases the risk of LV dysfunction and pacemaker-induced cardiomyopathy, but there have been no published studies on the cellular mechanism.
Does right ventricular septal pacemaker implantation alter cellular biomarkers (miR-155, IL-6, sTNFR-2, MMP-9, N-Cad, ZO-1) in TAVB patients who develop left ventricular dysfunction?
Does right ventricular septal pacemaker implantation alter cellular biomarkers (miR-155, IL-6, sTNFR-2, MMP-9, N-Cad, ZO-1) in TAVB patients who develop left ventricular dysfunction?
This study protocol outlines an investigation into the cellular mechanisms and biomarker changes associated with pacemaker-induced left ventricular dysfunction in patients with total AV block.
Does not alter pacing practice; leaves open cellular mechanisms of pacemaker-induced LV dysfunction in TAVB.
A permanent pacemaker (PPM) is currently the definitive treatment for patients with a total atrioventricular block (TAVB). The number of pacemaker implantation has been increasing every year. However, PPM implantation increases the risk of developing left ventricular (LV) dysfunction and becoming pacemaker-induced cardiomyopathy (PICM). There has never been a published study on the cellular mechanism of LV dysfunction caused by PPM implantation. The mechanism of pacemaker-induced left ventricular dysfunction (PILVD) study is a multi-center, quasi-experimental, etiognostic study with a time-series design. This etiognostic study aims to investigate the mechanism of cellular level changes in TAVB patients who had PPM implanted. In particular, the difference in serum miR-155 levels and plasma levels of IL-6, sTNFR-2, MMP-9, N-Cad, and ZO-1 in TAVB patients had LV dysfunction caused by right ventricular dysfunction septal PPM implantation measured by global longitudinal strain (GLS) obtained from echocardiography. Blood samples and echocardiographic examinations will be performed on patients who satisfied the inclusion criteria prior to pacemaker implantation, one month after, and three months following pacemaker implantation. The ELISA method will be used to assess IL-6, sTNFR-2, MMP-9, ZO-1, and N-Cad from plasma samples. MiR-155 levels in serum will be determined using the reverse-transcriptase polymerase chain reaction (RT-PCR) technique. The main findings are a decrease in serum miR-155 levels and increased plasma IL-6, sTNFR-2, MMP-9, N-Cad, and ZO-1 levels in TAVB patients who developed LV dysfunction due to right ventricular septal pacemaker implantation measured by GLS at 1 and 3 months.
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Laksono et al. (2022) studied Total atrioventricular block (TAVB) (n=240). Right ventricular septal permanent pacemaker implantation vs. Baseline (before implantation) and patients without LV dysfunction was evaluated on Changes in serum miR-155 and plasma IL-6, sTNFR-2, MMP-9, N-Cad, and ZO-1 levels at 1 and 3 months. Right ventricular septal permanent pacemaker implantation was associated with decreased miR-155 and increased IL-6, sTNFR-2, MMP-9, N-Cad, and ZO-1 levels in patients developing left ventricular dysfunction.
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