LV Remodeling Results in Homogenization of Work Distribution

This paper looked at the effect of inhomogeneous left ventricular work distribution on regional metabolism and remodeling in an animal model with reversible dyssynchrony due to pacing. The authors (using we sheep models) used invasive hemodynamics and echocardiography to assess regional work by stress-strain loop area. They also compared it to regional glucose metabolism by SPECT. The results, according to the authors, showed that “glucose metabolism by positron emission tomography with anatomic correction on gated positron emission tomography reconstruction showed a different regional distribution than with clinical reconstructions and correlated best and significantly with regional myocardial work.” According to the researchers, the data suggested “regionally different LV remodeling after exposure to inhomogeneous loading conditions, such as during LV dyssynchrony, is an adaptive process that helps to equilibrate work distribution.”

Duchenne J, Turco A, Unlu S, et al. Circ Arrythm Electrophysiol. 2019;doi:10.1161/CIRCEP.118.007224