Eccentric hypertrophy in an animal model of mid- and long-term premature ventricular contraction–induced cardiomyopathy
Background: Tachycardia and heart rate irregularity are proposed triggers of premature ventricular contraction–induced cardiomyopathy (PVC-cardiomyopathy). Bigeminal premature atrial and ventricular contractions (PACs and PVCs) increase heart rate and result in rhythm irregularities but differ in th...
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Elsevier
2021-02-01
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Series: | Heart Rhythm O2 |
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Online Access: | http://www.sciencedirect.com/science/article/pii/S2666501821000027 |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Juan Torrado, MD, PhD Gurukripa N. Kowlgi, MD Rafael J. Ramirez, PhD Jaime Balderas-Villalobos, PhD Daniel Jovin, BS Chandler Parker, BS Evani Om, BS Sergei Airapetov, DO Karoly Kaszala, MD, PhD, FHRS Alex Y. Tan, MD, FHRS Kenneth A. Ellenbogen, MD, FHRS Jose F. Huizar, MD, FHRS |
spellingShingle |
Juan Torrado, MD, PhD Gurukripa N. Kowlgi, MD Rafael J. Ramirez, PhD Jaime Balderas-Villalobos, PhD Daniel Jovin, BS Chandler Parker, BS Evani Om, BS Sergei Airapetov, DO Karoly Kaszala, MD, PhD, FHRS Alex Y. Tan, MD, FHRS Kenneth A. Ellenbogen, MD, FHRS Jose F. Huizar, MD, FHRS Eccentric hypertrophy in an animal model of mid- and long-term premature ventricular contraction–induced cardiomyopathy Heart Rhythm O2 Cardiomyopathy Eccentric hypertrophy Heart rate irregularity LV dyssynchrony Premature atrial contraction Premature ventricular contraction |
author_facet |
Juan Torrado, MD, PhD Gurukripa N. Kowlgi, MD Rafael J. Ramirez, PhD Jaime Balderas-Villalobos, PhD Daniel Jovin, BS Chandler Parker, BS Evani Om, BS Sergei Airapetov, DO Karoly Kaszala, MD, PhD, FHRS Alex Y. Tan, MD, FHRS Kenneth A. Ellenbogen, MD, FHRS Jose F. Huizar, MD, FHRS |
author_sort |
Juan Torrado, MD, PhD |
title |
Eccentric hypertrophy in an animal model of mid- and long-term premature ventricular contraction–induced cardiomyopathy |
title_short |
Eccentric hypertrophy in an animal model of mid- and long-term premature ventricular contraction–induced cardiomyopathy |
title_full |
Eccentric hypertrophy in an animal model of mid- and long-term premature ventricular contraction–induced cardiomyopathy |
title_fullStr |
Eccentric hypertrophy in an animal model of mid- and long-term premature ventricular contraction–induced cardiomyopathy |
title_full_unstemmed |
Eccentric hypertrophy in an animal model of mid- and long-term premature ventricular contraction–induced cardiomyopathy |
title_sort |
eccentric hypertrophy in an animal model of mid- and long-term premature ventricular contraction–induced cardiomyopathy |
publisher |
Elsevier |
series |
Heart Rhythm O2 |
issn |
2666-5018 |
publishDate |
2021-02-01 |
description |
Background: Tachycardia and heart rate irregularity are proposed triggers of premature ventricular contraction–induced cardiomyopathy (PVC-cardiomyopathy). Bigeminal premature atrial and ventricular contractions (PACs and PVCs) increase heart rate and result in rhythm irregularities but differ in their effects on ventricular synchrony. Comparing chronic bigeminal PACs with PVCs would provide insights into mechanisms of PVC-cardiomyopathy. Objective: To compare the impact of chronic PACs and PVCs on ventricular hemodynamics, structure, and function. Methods: Pacemakers were implanted in 27 canines to reproduce atrial (PACs, n = 7) or ventricular bigeminy (PVCs, n = 11) for 12 weeks, and compared to sham-operated animals (n = 9). Four additional animals were exposed to long-term bigeminal PVCs (48 weeks). Hemodynamic changes were assessed using a pressure-transducing catheter at baseline and 12 weeks. Cardiac remodeling was monitored by transthoracic echocardiography throughout the 12- and 48-week protocols in the respective groups. Results: PVC group demonstrated a significant decrease in left ventricular (LV) ejection fraction and contractility (max dP/dt), impaired LV lusitropy (min dP/dt), and increase in LV dimensions and LV mass at 12 weeks without further deterioration beyond 16 weeks. Despite increased LV mass, relative wall thickness decreased, consistent with eccentric hypertrophy. No significant cardiac remodeling was noted in either sham or PAC groups at 12 weeks. Conclusion: In contrast to bigeminal PACs, PVCs result in a cardiomyopathy characterized by reduced LV ejection fraction, LV dilation, and eccentric hypertrophy that plateaus between 12 and 16 weeks. The lack of remodeling in chronic PACs suggests that tachycardia and heart rate irregularity do not play a significant role on the development of PVC-cardiomyopathy. |
topic |
Cardiomyopathy Eccentric hypertrophy Heart rate irregularity LV dyssynchrony Premature atrial contraction Premature ventricular contraction |
url |
http://www.sciencedirect.com/science/article/pii/S2666501821000027 |
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doaj-2322b89a845d4095a90fbd43a6ff925d2021-09-03T04:47:29ZengElsevierHeart Rhythm O22666-50182021-02-01218088Eccentric hypertrophy in an animal model of mid- and long-term premature ventricular contraction–induced cardiomyopathyJuan Torrado, MD, PhD0Gurukripa N. Kowlgi, MD1Rafael J. Ramirez, PhD2Jaime Balderas-Villalobos, PhD3Daniel Jovin, BS4Chandler Parker, BS5Evani Om, BS6Sergei Airapetov, DO7Karoly Kaszala, MD, PhD, FHRS8Alex Y. Tan, MD, FHRS9Kenneth A. Ellenbogen, MD, FHRS10Jose F. Huizar, MD, FHRS11Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia; Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VirginiaPauley Heart Center, Virginia Commonwealth University, Richmond, VirginiaPauley Heart Center, Virginia Commonwealth University, Richmond, Virginia; Department of Physiology and Biophysics, Virginia Commonwealth University, Richmond, VirginiaPauley Heart Center, Virginia Commonwealth University, Richmond, Virginia; Department of Physiology and Biophysics, Virginia Commonwealth University, Richmond, VirginiaHunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VirginiaHunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VirginiaPauley Heart Center, Virginia Commonwealth University, Richmond, Virginia; Department of Physiology and Biophysics, Virginia Commonwealth University, Richmond, VirginiaPauley Heart Center, Virginia Commonwealth University, Richmond, Virginia; Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VirginiaPauley Heart Center, Virginia Commonwealth University, Richmond, Virginia; Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VirginiaPauley Heart Center, Virginia Commonwealth University, Richmond, Virginia; Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VirginiaPauley Heart Center, Virginia Commonwealth University, Richmond, VirginiaPauley Heart Center, Virginia Commonwealth University, Richmond, Virginia; Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia; Department of Physiology and Biophysics, Virginia Commonwealth University, Richmond, Virginia; Address reprint requests and correspondence: Dr Jose F. Huizar, Associate Professor of Medicine, Virginia Commonwealth University / Pauley Heart Center, Hunter Holmes McGuire VA Medical Center, 1201 Broad Rock Blvd, Ste. 4A-100, Richmond, VA 23249.Background: Tachycardia and heart rate irregularity are proposed triggers of premature ventricular contraction–induced cardiomyopathy (PVC-cardiomyopathy). Bigeminal premature atrial and ventricular contractions (PACs and PVCs) increase heart rate and result in rhythm irregularities but differ in their effects on ventricular synchrony. Comparing chronic bigeminal PACs with PVCs would provide insights into mechanisms of PVC-cardiomyopathy. Objective: To compare the impact of chronic PACs and PVCs on ventricular hemodynamics, structure, and function. Methods: Pacemakers were implanted in 27 canines to reproduce atrial (PACs, n = 7) or ventricular bigeminy (PVCs, n = 11) for 12 weeks, and compared to sham-operated animals (n = 9). Four additional animals were exposed to long-term bigeminal PVCs (48 weeks). Hemodynamic changes were assessed using a pressure-transducing catheter at baseline and 12 weeks. Cardiac remodeling was monitored by transthoracic echocardiography throughout the 12- and 48-week protocols in the respective groups. Results: PVC group demonstrated a significant decrease in left ventricular (LV) ejection fraction and contractility (max dP/dt), impaired LV lusitropy (min dP/dt), and increase in LV dimensions and LV mass at 12 weeks without further deterioration beyond 16 weeks. Despite increased LV mass, relative wall thickness decreased, consistent with eccentric hypertrophy. No significant cardiac remodeling was noted in either sham or PAC groups at 12 weeks. Conclusion: In contrast to bigeminal PACs, PVCs result in a cardiomyopathy characterized by reduced LV ejection fraction, LV dilation, and eccentric hypertrophy that plateaus between 12 and 16 weeks. The lack of remodeling in chronic PACs suggests that tachycardia and heart rate irregularity do not play a significant role on the development of PVC-cardiomyopathy.http://www.sciencedirect.com/science/article/pii/S2666501821000027CardiomyopathyEccentric hypertrophyHeart rate irregularityLV dyssynchronyPremature atrial contractionPremature ventricular contraction |