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Pacing induced cardiomyopathy is associated with reduced myocardial blood flow, hyperinsulinemia and enhanced myocardial glucose metabolism

Session Poster session 1 Saturday 08:30 -17:30

Speaker Danilo Neglia

Event : Heart Failure 2015

  • Topic : basic science
  • Sub-topic : Basic Science
  • Session type : Poster Session

Authors : M Marinelli (Pisa,IT), C Vecoli (Pisa,IT), A Pippa (Pisa,IT), S Burchielli (Pisa,IT), L Panchetti (Pisa,IT), F Bernini (Pisa,IT), S Pardini (Pisa,IT), M Piacenti (Pisa,IT), MA Morales (Pisa,IT), D Neglia (Pisa,IT)

M Marinelli1 , C Vecoli1 , A Pippa2 , S Burchielli3 , L Panchetti3 , F Bernini2 , S Pardini1 , M Piacenti3 , MA Morales1 , D Neglia3 , 1CNR-Istituto Fisiologia Clinica - Pisa - Italy , 2High School Sant'Anna - Pisa - Italy , 3Fondazione G. Monasterio CNR - Regione Toscana - Pisa - Italy ,

European Journal of Heart Failure Abstracts Supplement ( 2015 ) 17 ( Supplement 1 ), 124

Purpose: Prolonged right ventricular (RV) pacing at high heart rate (HR) induces left ventricle (LV) dysfunction, endothelial dysfunction and nitric oxide deficiency in the experimental model. Purpose of this study was to assess whether this may translate into abnormalities of regional myocardial blood flow (MBF), systemic and myocardial metabolism as possible determinants of progressive heart failure.

Methods: Seven adult minipigs underwent RV apical pacing (220 beats/min) for 4 weeks. Positron emission tomography, 2D-echocardiography (ECHO) and venous blood sampling were performed at baseline (PRE) and soon after interruption of 4 weeks high rate pacing (POST). Regional myocardial blood flow (MBF) ([13N]ammonia as a flow tracer) and fasting glucose uptake (MGU) ([18F]fluorodeoxiglucose as a metabolic tracer) were quantitated in 17 LV segments from PET data. LV fractional shortening (FS) was computed from ECHO. Lipid and glucose profiles were measured from blood samples.

Results: From PRE to POST, FS significantly decreased from 32.6 ± 3.4% to 15.8 ± 1.6% (p < 0.001). Regional MBF significantly decreased from 1.08 ± 0.25 to 0.88 ± 0.28 ml/min/g (p < 0.001) while regional MGU increased from 2.0 ± 2.7 to 10.4 ± 7.7 mmol/min/100g (P < 0.001). Insuline levels increased from 1.29 ± 1.05 to 3,30 ± 1,51 U/mL (P < 0.01) and HDL cholesterol decreased from 29.0 ± 8.4 to 17.7 ± 10.4 mg/dL (P < 0.05) while all the other parameters remained unchanged. Regional MGU was inversely correlated with MBF (P < 0.001) and directly correlated with insulinemia (P < 0.05).

Conclusions: Prolonged high rate pacing in minipigs causes reduction in LV function, decrease in regional MBF and hyperinsulinemia as possible effects of endothelial dysfunction. These changes are mirrored by a compensatory increase in myocardial glucose metabolism which may exert a protective effect against progressive cardiac damage.

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