7 results on '"GADLER, FREDRIK"'
Search Results
2. Changes in global longitudinal strain during rest and exercise in patients treated with cardiac resynchronization therapy.
- Author
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Valzania, Cinzia, Gadler, Fredrik, Boriani, Giuseppe, and Eriksson, Maria J.
- Subjects
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HEART diseases , *THERAPEUTICS , *ECHOCARDIOGRAPHY , *FOLLOW-up studies (Medicine) , *EXERCISE , *MEDICAL protocols , *PHYSIOLOGIC strain - Abstract
Relatively few data have been reported on prospective changes in global longitudinal strain ( GLS) following cardiac resynchronization therapy ( CRT), and none are available on GLS during physical exercise. We investigated the effects of CRT on GLS, assessed by speckle tracking two-dimensional (2 D) echocardiography, at rest and during exercise after a mid-term follow-up. Twenty consecutive CRT patients (45% ischaemic) were assessed prospectively by speckle tracking 2 D echocardiography before implant (at rest) and at mid-term follow-up (during rest and bicycle exercise). GLS, septum and lateral wall longitudinal strain, left ventricular ejection fraction ( LVEF), and conventional functional variables were evaluated at baseline and follow-up. All patients completed the study protocol at rest. Exercise images were available in 90% of the patients. At follow-up, GLS improved at rest from −7·1 ± 2·6% to −9·1 ± 4·5% ( P<0·01), with a further increase to −11 ± 5·1% during exercise ( P<0·001). Longitudinal strain increased at rest both in the septum and in the lateral wall, with an additional increase during exercise in the lateral wall ( P<0·05). GLS correlated with LVEF both at rest ( r = −0·55 and r = −0·91 at baseline and 3 months, respectively; P<0·05) and during exercise ( r = −0·89, P<0·05). Improvement in GLS during rest and exercise can be observed in CRT patients at mid-term follow-up and seems to correlate with changes in LVEF. GLS may be a valuable method to assess left ventricular function during rest and exercise. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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3. Effects of cardiac resynchronization therapy on myocardial contractile reserve during exercise.
- Author
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Valzania, Cinzia, Gadler, Fredrik, Boriani, Giuseppe, and Eriksson, Maria J.
- Subjects
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HEART failure patients , *TREATMENT of cardiomyopathies , *ECHOCARDIOGRAPHY , *MEDICAL imaging systems , *REST , *EXERCISE , *PATIENT selection - Abstract
Aims Myocardial contractile reserve (MCR) is a marker of myocardial viability. The impact of cardiac resynchronization therapy (CRT) on MCR during exercise has been little studied. Our aim was to investigate the effects of CRT on global and regional MCR by exercise echocardiography. Methods and results Twenty-seven CRT responders (56% ischaemic) were assessed by echocardiography during rest and bicycle exercise. Images were acquired during spontaneous rhythm (‘off') and active CRT (‘on'). Global MCR was expressed as the change (Δ) in left ventricular ejection fraction (LVEF) and aortic velocity-time integral (VTI) from rest to exercise. Regional MCR was expressed as the change in peak systolic tissue velocity (Sm) of the septum and lateral wall. Left ventricular ejection fraction and aortic VTI increased at ‘on' during rest and exercise, and the increase in global MCR during exercise was higher during ‘on' than ‘off' (Δ LVEF 6 ± 6 vs. 3 ± 3%; P= 0.009). Septum Sm increased during ‘on' at rest, and it was still higher during exercise (P≤ 0.01), although the absolute change from rest to exercise was similar during ‘on' and ‘off'. Lateral wall Sm did not change at rest during ‘on', but basal lateral wall MCR during exercise was higher at ‘on' than ‘off' (P= 0.036). Conclusion In CRT responders, there is a pacing-dependent increase in global MCR during exercise. The changes in regional MCR of the septum and lateral wall show different patterns. These factors may help to understand the determinants of improved exercise tolerance in CRT responders. [ABSTRACT FROM PUBLISHER]
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- 2011
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4. Cardiac resynchronization therapy during rest and exercise: comparison of two optimization methods.
- Author
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Valzania, Cinzia, Eriksson, Maria J., Boriani, Giuseppe, and Gadler, Fredrik
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Aims: Optimal exercise programming of cardiac resynchronization therapy (CRT) devices is unknown. We aimed to: (i) investigate variations in optimal atrioventricular (AV) and interventricular (VV) delays from rest to exercise, assessed by both echocardiography and an automated intracardiac electrogram (IEGM) method; (ii) evaluate the acute haemodynamic impact of CRT optimization performed during exercise. [ABSTRACT FROM PUBLISHER]
- Published
- 2008
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5. Effects of cardiac resynchronization therapy on coronary blood flow: Evaluation by transthoracic Doppler echocardiography
- Author
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Valzania, Cinzia, Gadler, Fredrik, Winter, Reidar, Braunschweig, Frieder, Brodin, Lars-Åke, Gudmundsson, Petri, Boriani, Giuseppe, and Eriksson, Maria J.
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CARDIAC rehabilitation , *HEART blood-vessels , *BLOOD flow , *MYOCARDIUM , *HEART septum - Abstract
Abstract: Background: Relatively limited and conflicting data are available on the effects of cardiac resynchronization therapy (CRT) on coronary blood flow (CBF). Aims: To investigate changes in the left anterior descending coronary artery (LAD) flow under different CRT pacing modes by means of transthoracic Doppler echocardiography (TTE). Methods: Twenty-two responders to CRT (67±11 years) with idiopathic dilated cardiomyopathy underwent TTE assessment of LAD flow and Tissue Velocity Imaging during 4 programming modes: intrinsic conduction (IC), right ventricular pacing (RV), simultaneous biventricular pacing (BVP), BVP with left ventricular (LV) pre-activation. Results: Mean coronary flow velocity (CFV) was increased by simultaneous BVP (p =0.0063 vs. IC) and BVP with LV pre-activation (p <0.0001 vs. IC; p =0.027 vs. simultaneous BVP). Peak CFV and LAD flow velocity/time integral were highest during BVP with LV pre-activation. A reduction in septal-to-lateral delay and an increase in peak systolic velocity in the basal septum were observed during simultaneous BVP and BVP with LV pre-activation. Conclusions: In CRT responders with idiopathic dilated cardiomyopathy, an increase in LAD flow, assessed by TTE, was observed during simultaneous BVP and BVP with LV pre-activation. This was associated with an improvement in regional myocardial contraction and a decrease in intraventricular dyssynchrony. [Copyright &y& Elsevier]
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- 2008
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6. Electromechanical effects of cardiac resynchronization therapy during rest and stress in patients with heart failure
- Author
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Valzania, Cinzia, Gadler, Fredrik, Eriksson, Maria J., Olsson, Arne, Boriani, Giuseppe, and Braunschweig, Frieder
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HEMODYNAMICS , *PATIENT-ventilator dyssynchrony , *ELECTROMECHANICAL devices , *DOBUTAMINE , *ECHOCARDIOGRAPHY - Abstract
Abstract: Background: Haemodynamic and functional effects of cardiac resynchronization therapy (CRT) have been studied mostly at rest. CRT effects on left ventricular (LV) dyssynchrony and function during stress have not been evaluated in detail. Aims: We studied the electromechanical effects of CRT at rest and during Dobutamine stress echocardiography (DSE), during active and withheld CRT. Methods: Twenty-one responders to CRT (62±12 yr) were assessed by walking test, quality of life, and BNP with active CRT (“on”) and 2 weeks after pacing withdrawal (“off”). DSE (10 μg/kg/min) was performed both at “on” and “off” to evaluate dyssynchrony parameters, systolic and diastolic function. Results: At rest, CRT withdrawal was associated with an increased interventricular mechanical delay (IVMD, from 21±18 ms to 49±24 ms, p <0.001) and impaired intraventricular synchrony. There was a significant decrease in LV systolic function and LV filling time. Dobutamine infusion had no impact on inter- and intraventricular synchrony. During stress, there was an improvement in LV performance both at “on” and “off”. However, LV dp/dt, aortic VTI, cardiac output, mean systolic peak velocities and LV filling time during dobutamine stress were significantly greater with CRT “on”. Conclusion: In long-term responders, CRT improves LV performance both at rest and during dobutamine stress. This is attributable to an improvement in LV synchrony, which is maintained during stress. [Copyright &y& Elsevier]
- Published
- 2007
- Full Text
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7. Effect of Cardiac Resynchronization Therapy on Left Atrial Size and Function as Expressed by Speckle Tracking 2-Dimensional Strain
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Fredrik Gadler, Giuseppe Boriani, Maria Eriksson, Cinzia Valzania, Claudio Rapezzi, Valzania, Cinzia, Gadler, Fredrik, Boriani, Giuseppe, Rapezzi, Claudio, and Eriksson, Maria J.
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Male ,medicine.medical_treatment ,Cardiology and cardiovascular medicine ,Left ,cardiac resynchronization therapy ,Speckle tracking echocardiography ,030204 cardiovascular system & hematology ,Doppler echocardiography ,cardiac resynchronization therapy, ventricular diastolic function ,preserved ejection fraction ,heart-failure patients ,longitudinal strain ,filling pressures ,volume ,echocardiography ,optimization ,contraction ,improvement ,Cardiac Resynchronization Therapy ,0302 clinical medicine ,Diastole ,Prospective Studies ,030212 general & internal medicine ,Ejection fraction ,medicine.diagnostic_test ,Doppler ,Mitral Valve Insufficiency ,Organ Size ,Stroke volume ,Middle Aged ,Atrial Function ,Echocardiography, Doppler ,Treatment Outcome ,Echocardiography ,Aged ,Female ,Heart Atria ,Heart Failure ,Humans ,Stroke Volume ,Atrial Function, Left ,Atrial Remodeling ,Cardiology and Cardiovascular Medicine ,cardiovascular system ,Cardiology ,medicine.medical_specialty ,Cardiology and Cardiovascular Medicine,Cardiac Resynchronization Therapy ,Cardiac resynchronization therapy ,NO ,03 medical and health sciences ,Internal medicine ,medicine ,cardiovascular diseases ,ventricular diastolic function ,Mitral regurgitation ,business.industry ,medicine.disease ,Heart failure ,business - Abstract
Changes in left atrial (LA) strain in patients treated with cardiac resynchronization therapy (CRT) remain not entirely explored. We prospectively evaluated long-term changes in LA size and function and their relation with left ventricular (LV) reverse remodeling and noninvasive hemodynamic variables in patients treated with CRT by 2-dimensional speckle tracking echocardiography. Thirty patients (62 ± 11 years, 63% men) underwent 2-dimensional speckle tracking echocardiography before implant and after 12 months. LA area, global and regional LA strains, LV ejection fraction (LVEF) and longitudinal strain, mitral regurgitation (MR), and diastolic variables were evaluated. At 12 months, CRT responders (60%) exhibited an increase in LA strain (11.4 ± 6.5% vs 16.5 ± 7.9%, p
- Published
- 2016
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