Correlation between electromechanical parameters (NOGA XP) and changes of myocardial ischemia in patients with refractory angina

Radosław Kurzelowski; Kamil Barański; Guido Caluori; Wojciech Szot; Krzysztof Grabowski; Aleksandra Michalewska-Włudarczyk; Marcin Syzdół; Wacław Kuczmik; Anna Błach; Beata Ochała; Damian Hudziak; Jacek Wilczek; Krzysztof S. Gołba; Zdenek Starek; Michał Tendera; Wojciech Wojakowski; Tomasz Jadczyk

doi:10.5114/aic.2021.109168

eISSN: 1897-4295
ISSN: 1734-9338

Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej

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abstract:

Original paper

Correlation between electromechanical parameters (NOGA XP) and changes of myocardial ischemia in patients with refractory angina

Radosław Kurzelowski

¹

,

Kamil Barański

²

,

Guido Caluori

^{3, 4}

,

Wojciech Szot

⁵

,

Krzysztof Grabowski

⁶

,

Aleksandra Michalewska-Włudarczyk

¹

,

Marcin Syzdół

¹

,

Wacław Kuczmik

⁷

,

Anna Błach

¹

,

Beata Ochała

¹

,

Damian Hudziak

⁸

,

Jacek Wilczek

⁹

,

Krzysztof S. Gołba

⁹

,

Zdenek Starek

^{10, 11}

,

Michał Tendera

¹

,

Wojciech Wojakowski

¹

,

Tomasz Jadczyk

^{1, 10}

Department of Cardiology and Structural Heart Disease, Medical University of Silesia, Katowice, Poland

Department of Epidemiology, Medical University of Silesia, Katowice, Poland

IHU LIRYC, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac, France

Univ. Bordeaux, INSERM, UMR 1045, Cardiothoracic Research Center of Bordeaux, Pessac, France

Department of Nuclear Medicine, John Paul II Hospital, Jagiellonian University Medical College, Krakow, Poland

Department of Robotics and Mechatronics, AGH University of Science and Technology, Krakow, Poland

Department of General and Vascular Surgery, Medical University of Silesia, Katowice, Poland

Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland

Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland

10.

Interventional Cardiac Electrophysiology Group, International Clinical Research Center, St. Anne’s University Hospital, Brno, Czech Republic

11.

1st Department of Internal Medicine – Cardioangiology, St. Anne’s University Hospital, Brno, Czech Republic

Adv Interv Cardiol 2021; 17, 3 (65): 281–289

DOI: https://doi.org/10.5114/aic.2021.109168

Online publish date: 2021/09/14

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AMA

Kurzelowski R, Barański K, Caluori G, et al. Correlation between electromechanical parameters (NOGA XP) and changes of myocardial ischemia in patients with refractory angina. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2021;17(3):281-289. doi:10.5114/aic.2021.109168.

APA

Kurzelowski, R., Barański, K., Caluori, G., Szot, W., Grabowski, K.,  & Michalewska-Włudarczyk, A. et al. (2021). Correlation between electromechanical parameters (NOGA XP) and changes of myocardial ischemia in patients with refractory angina. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 17(3), 281-289. https://doi.org/10.5114/aic.2021.109168

Chicago

Kurzelowski, Radosław, Kamil Barański, Guido Caluori, Wojciech Szot, Krzysztof Grabowski, Aleksandra Michalewska-Włudarczyk,  and Marcin Syzdół et al. 2021. "Correlation between electromechanical parameters (NOGA XP) and changes of myocardial ischemia in patients with refractory angina". Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej 17 (3): 281-289. doi:10.5114/aic.2021.109168.

Harvard

Kurzelowski, R., Barański, K., Caluori, G., Szot, W., Grabowski, K., Michalewska-Włudarczyk, A., Syzdół, M., Kuczmik, W., Błach, A., Ochała, B., Hudziak, D., Wilczek, J., Gołba, K., Starek, Z., Tendera, M., Wojakowski, W.,  and Jadczyk, T. (2021). Correlation between electromechanical parameters (NOGA XP) and changes of myocardial ischemia in patients with refractory angina. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 17(3), pp.281-289. https://doi.org/10.5114/aic.2021.109168

MLA

Kurzelowski, Radosław et al. "Correlation between electromechanical parameters (NOGA XP) and changes of myocardial ischemia in patients with refractory angina." Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, vol. 17, no. 3, 2021, pp. 281-289. doi:10.5114/aic.2021.109168.

Vancouver

Kurzelowski R, Barański K, Caluori G, Szot W, Grabowski K, Michalewska-Włudarczyk A et al. Correlation between electromechanical parameters (NOGA XP) and changes of myocardial ischemia in patients with refractory angina. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2021;17(3):281-289. doi:10.5114/aic.2021.109168.

Introduction
Cell therapy has the potential to improve symptoms and clinical outcomes in refractory angina (RFA). Further analyses are needed to evaluate factors influencing its therapeutic effectiveness. Aim: Assessment of electromechanical (EM) parameters of the left ventricle (LV) and investigation of correlation between EM parameters of the myocardium and response to CD133+ cell therapy.

Material and methods
Thirty patients with RFA (16 active and 14 placebo individuals) enrolled in the REGENT-VSEL trial underwent EM evaluation of the LV with intracardiac mapping system. The following parameters were analyzed: unipolar voltage (UV), bipolar voltage (BV), local linear shortening (LLS). Myocardial ischemia was evaluated with single-photon emission computed tomography (SPECT). The median value of each EM parameter was used for intra-group comparisons.

Results
Global EM parameters (UV, BV, LLS) of LV in active and placebo groups were 11.28 mV, 3.58 mV, 11.12%, respectively; 13.00 mV, 3.81 mV, 11.32%, respectively. EM characteristics analyzed at global and segmental levels did not predict response to CD133+ cell therapy in patients with RFA (Global UV, BV and LLS at rest R = –0.06; R = 0.2; R = –0.1 and at stress: R = 0.07, R = 0.09, R = –0.1, respectively; Segmental UV, BV, LLS at rest R = –0.2, R = 0.03, R = –0.4 and at stress R = 0.02, R = 0.2, R = –0.2, respectively). Multiple linear regression of the treated segments showed that only pre-injection SPECT levels were significantly correlated with post-injection SPECT, either at rest or stress (p < 0.05).

Conclusions
Electromechanical characteristics of the left ventricle do not predict changes of myocardial perfusion by SPECT after cell therapy. Baseline SPECT results are only predictors of changes of myocardial ischemia observed at 4-month follow-up.

keywords:

Correlation between electromechanical parameters (NOGA XP) and changes of myocardial ischemia in patients with refractory angina

electromechanical mapping, refractory angina, CD133+, cell therapy, NOGA XP