Speckle tracking imaging evaluation of left ventricular myocardial work comparing right ventricular septal pacing with His-Purkinje system area pacing

Qingguo Meng; Yao Li; Sijia Wang; Tianhang Feng; Huijun Xu; Juan Liu; Xuebing Liu; Zhiyu Guo; Yan Deng; Chunmei Li; Yijia Tang; Lixue Yin

doi:10.3389/fcvm.2022.949841

Speckle tracking imaging evaluation of left ventricular myocardial work comparing right ventricular septal pacing with His-Purkinje system area pacing

Front Cardiovasc Med. 2022 Oct 25:9:949841. doi: 10.3389/fcvm.2022.949841. eCollection 2022.

Authors

Qingguo Meng¹, Yao Li², Sijia Wang¹, Tianhang Feng³, Huijun Xu⁴, Juan Liu⁵, Xuebing Liu¹, Zhiyu Guo³, Yan Deng¹, Chunmei Li¹, Yijia Tang³, Lixue Yin¹

Affiliations

¹ Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
² Department of Cardiac Function, Chengdu First People's Hospital, Chengdu, China.
³ Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
⁴ Department of Gerontology, Xiqing Hospital, Tianjin, China.
⁵ Chengdu Women's and Children's Central Hospital, Chengdu, China.

Abstract

Aims: We sought to objectively assess left ventricular myocardial work (MW) parameters after right ventricular septal pacing (VSP) and His-Purkinje system area pacing (HPSAP) procedures.

Materials and methods: Patients undergoing double-chamber pacemaker implantation for III-degree atrioventricular block (III° AVB) were assessed 1 year after implantation. VSP and HPSAP groups (20 and 23 patients, respectively) were compared against 40 healthy age-matched volunteers. Two-dimensional ultrasound speckle tracking imaging was used to obtain the global myocardial work index (GWI), global myocardial work efficiency (GWE), global myocardial constructive work (GCW), global myocardial wasted work (GWW), left ventricular stratified strain, and peak strain dispersion (PSD).

Results: GWI, GWE, and GCW parameters were improved in HPSAP compared to VSP, while GWW was significantly larger in the VSP group compared to the HPSAP group (all p < 0.05). HPSAP outperformed the VSP group in comparisons of global left ventricular longitudinal strain and stratified strain. Compared to controls, the GCW of all segmental myocardium (17/17 segments) in the VSP group was significantly reduced, while 70.59% (12/17 segments) in the HPSAP group was lower than the control group. GCW in the left ventricular segment of the HPSAP group was bigger than the VSP group (29.41%; 5/17 segments) and mainly concentrated in the ventricular septum and inferior wall.

Conclusion: Our findings suggest that HPSAP performance outcomes are improved over VSP after 1 year, especially in left ventricular contractile synchrony, and HPSAP is beneficial to the effective myocardial work of the left ventricle.

Keywords: His-Purkinje system area pacing; constructive work; myocardial work; right ventricular septal pacing; work efficiency.