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Effects of Rapid Pacing Stress on Ventricular Function of Hypertrophied Human Heart

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Recent Progress in Failing Heart Syndrome

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Summary

Rapid pacing stress has been used to study hemodynamics, ventricular function and metabolism in, ischemic heart disease. This method was applied to patients with left ventricular hypertrophy but without coronary artery disease in order to gain an insight into the mechanism responsible for the transition from compensation to failure in cardiac hypertrophy. Seven patients with LV hypertrophy (H) (three patients with aortic stenosis and four patients with hypertrophic non-obstructive cardiomyopathy) and six controls with chest pain syndrome (C) were studied. The coronary arteriograms were normal and no LV dysfunction was present on pre-pacing LV grams in all the cases. Although the pre-pacing LV ejection fractions (EF) were not different in the two groups, the post-pacing EF diminished in H (68.2 ± 7.8 to 63.5 ± 12.8%, P < 0.05), but not in C. The pre-pacing LV end-diastolic pressure (EDP) was slightly higher in H (H, 14.4 ± 6.5; C, 9.0 ± 2.2mmHg, P < 0.05), and EDP increased markedly after pacing only in H (30.0 ± 7.4mmHg, P < 0.01), while the LV end-diastolic volume index in H increased slightly (80.3 ± 29.7 to 86.4 ± 25.3ml/M2, n.s.), indicating a decrease in LV chamber compliance with pacing in H. Thus, LV systolic function and chamber compliance deteriorate with pacing in hypertrophied hearts with normal LV contraction before pacing. Susceptibility to pacing stress may suggest a role of the diminished coronary reserve in the development of ultimate failure in hypertrophy.

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Authors and Affiliations

  1. First Department of Medicine, Shiga University of Medical Science, Shiga, 520-21, Japan

    Yasuyuki Nakamura

  2. Third Division, Department of Internal Medicine, Faculty of Medicine, Kyoto University, Japan

    Takashi Konishi, Toshiaki Kumada & Chuichi Kawai

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  1. Yasuyuki Nakamura
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  2. Takashi Konishi
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  3. Toshiaki Kumada
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  4. Chuichi Kawai
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Editors and Affiliations

  1. The Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, 2630 Sugitani, 930-01, Toyama, Japan

    Shigetake Sasayama M.D. (Professor of Medicine) (Professor of Medicine)

  2. Okayama University Medical School, 2-5-1, Shikata-cho, 700, Okayama, Japan

    Hiroyuki Suga M.D., D.M. SC. (Professor of Physiology) (Professor of Physiology)

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© 1991 Springer-Verlag Tokyo

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Nakamura, Y., Konishi, T., Kumada, T., Kawai, C. (1991). Effects of Rapid Pacing Stress on Ventricular Function of Hypertrophied Human Heart. In: Sasayama, S., Suga, H. (eds) Recent Progress in Failing Heart Syndrome. Springer, Tokyo. https://doi.org/10.1007/978-4-431-67955-4_10

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  • DOI: https://doi.org/10.1007/978-4-431-67955-4_10

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-68019-2

  • Online ISBN: 978-4-431-67955-4

  • eBook Packages: Springer Book Archive

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