Lower pre-implant left ventricular global longitudinal strain was independently associated with the development of pacing-induced cardiomyopathy (HR 1.27; 95% CI 1.009-1.492; P=0.004).
Cohort (n=80)
Does pre-implant LV GLS predict pacing-induced cardiomyopathy in patients with complete atrioventricular block?
Lower baseline left ventricular global longitudinal strain is an independent predictor of pacing-induced cardiomyopathy in patients with complete atrioventricular block and normal baseline LV function.
Hazard Ratio: 1.27 (95% CI 1.009–1.492)
p-value: p=0.004
INTRODUCTION: Long-term right ventricular pacing is the only treatment for patients with a complete atrioventricular block (CAVB); however, it frequently triggers ventricular dys-synchrony with left ventricular (LV) dysfunction. Previous studies showed that an early decline of LV global longitudinal strain (GLS) predicts pacing-induced LV dysfunction. We aimed to investigate the potential ability of the initial LV strain to predict pacing-induced cardiomyopathy (PICM) through long-term follow-ups. METHODS: We retrospectively enrolled 80 patients with CAVB with normal LV function who were implanted with dual-chamber pacemakers between 2008 and 2018. Echocardiographic data and parameters (including longitudinal, radial, and circumferential strain based on speckle-tracking) were analyzed for the pre-implant (≤6 months) and post-implant periods. PICM was defined as a ≥10% reduction in the left ventricular ejection fraction (LVEF) resulting in an LVEF of <50% during the post-implant period. Predictors of PICM were identified using Cox proportional hazard models. RESULTS: Patients who developed PICM were more likely to exhibit lower baseline LV GLS, as well as wider native and pacing QRS durations, than those who did not develop PICM (P = .016, P = .011, and P = .026, respectively). In the multivariate analysis, pre-implant LV GLS (hazard ratio: 1.27; 95% confidence interval 1.009-1.492; P = .004) was independently associated with the development of PICM. CONCLUSION: A lower baseline LV GLS predicts an increased risk of PICM. Patients with CAVB exhibiting low GLS are at increased risk of PICM. More frequent follow-up visits are warranted in these patients, who may also require de novo His-bundle pacing or an upgrade to biventricular pacing.
Chin et al. (Wed,) conducted a cohort in Complete atrioventricular block (n=80). Pre-implant left ventricular global longitudinal strain was evaluated on Pacing-induced cardiomyopathy (≥10% reduction in LVEF resulting in an LVEF of <50% during the post-implant period) (HR 1.27, 95% CI 1.009-1.492, p=0.004). Lower pre-implant left ventricular global longitudinal strain was independently associated with the development of pacing-induced cardiomyopathy (HR 1.27; 95% CI 1.009-1.492; P=0.004).
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