Positron Emission Tomographic Demonstration of Myocardial Oxidative Metabolism in a Case of Left Ventricular Restoration After Cardiac Resynchronization Therapy

Kenji Kitaizumi; Kazushi Yukiiri; Hisashi Masugata; Kaori Shinomiya; Minako Ohara; Hiroyuki Takinami; Yasuyoshi Iwado; Junji Yoshida; Takahisa Noma; Koji Ohmori; Yoichi Yamashita; Taiko Horii; Shoich Senda; Masakazu Kohno

doi:10.1253/circj.CJ-07-1011

Case Report

Positron Emission Tomographic Demonstration of Myocardial Oxidative Metabolism in a Case of Left Ventricular Restoration After Cardiac Resynchronization Therapy

Kenji Kitaizumi, Kazushi Yukiiri, Hisashi Masugata, Kaori Shinomiya, Minako Ohara, Hiroyuki Takinami, Yasuyoshi Iwado, Junji Yoshida, Takahisa Noma, Koji Ohmori, Yoichi Yamashita, Taiko Horii, Shoich Senda, Masakazu Kohno

Author information

Kenji Kitaizumi
Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University
Kazushi Yukiiri
Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University
Hisashi Masugata
Department of Integrated Medicine, Kagawa University
Kaori Shinomiya
Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University
Minako Ohara
Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University
Hiroyuki Takinami
Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University
Yasuyoshi Iwado
Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University
Junji Yoshida
Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University
Takahisa Noma
Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University
Koji Ohmori
Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University
Yoichi Yamashita
Department of Cardiovascular Surgery, Kagawa University
Taiko Horii
Department of Cardiovascular Surgery, Kagawa University
Shoich Senda
Department of Integrated Medicine, Kagawa University
Masakazu Kohno
Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University

Keywords: Cardiac resynchronization therapy, Left ventricular papillary muscle imbrication, Positron emission tomography

JOURNAL FREE ACCESS

2008 Volume 72 Issue 11 Pages 1900-1903

DOI https://doi.org/10.1253/circj.CJ-07-1011

View "Advance Publication" version (September 11, 2008).

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Abstract

A 65-year-old man with a history of coronary artery bypass grafting was admitted because of severe heart failure. Echocardiography showed diffuse severe hypokinesis of the left ventricle (ejection fraction 25%) and severe mitral regurgitation caused by tethering of the leaflet secondary to left ventricular (LV) dilation. He underwent mitral valve annuloplasty and LV papillary muscle imbrication, but postoperative sustained ventricular tachycardia developed and echocardiography showed ventricular dyssynchrony with a long septal-to-posterior wall motion delay (>130 ms). Cardiac resynchronization therapy (CRT) was performed using a biventricular pacing system with an implantable cardioverter defibrillator, but biventricular pacing prolonged the QRS duration from 130 to 160 ms, so ¹¹C-acetate positron emission tomography was performed to evaluate the CRT. During biventricular pacing, myocardial oxidative consumption decreased by 15% and cardiac efficiency increased by 33%. The plasma brain natriuretic peptide level, which was 9,500 pg/ml preoperatively, decreased to 173 pg/ml just before discharge from hospital. (Circ J 2008; 72: 1900 - 1903)

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