{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T04:11:53Z","timestamp":1771906313105,"version":"3.50.1"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2011,5]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>The objective of the present study was to investigate the effect of cardiac resynchronization therapy (CRT) on cardiac autonomic function.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              This prospective study included 45 consecutive patients with heart failure who received CRT devices with defibrillator and 20 age-matched, healthy control subjects. At baseline and 3 months and 6 months after CRT, we assessed New York Heart Association (NYHA) class, 6-minute walk distance, plasma sympathetic biomarker nerve growth factor, echocardiography, heart rate variability and cardiac presynaptic sympathetic function determined by iodine 123 metaiodobenzylguanidine scintigraphy. After CRT, NYHA class improved by 1 class (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), and left ventricular ejection fraction increased by 8% (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Along with improvement in the standard deviation of all normal-to-normal R-R intervals (85.63\u00b131.66 ms versus 114.79\u00b138.99 ms;\n              <jats:italic>P<\/jats:italic>\n              =0.004) and the standard deviation of the averaged normal-to-normal R-R intervals (82.62\u00b123.03 ms versus 100.50\u00b134.87 ms;\n              <jats:italic>P<\/jats:italic>\n              =0.004), the delayed heart\/mediastinum (H\/M) ratio increased (1.82 [0.58] versus 1.97 [0.59];\n              <jats:italic>P<\/jats:italic>\n              =0.03), whereas the mean (SD) H\/M washout rate was reduced (48% [19%] versus 37% [22%];\n              <jats:italic>P<\/jats:italic>\n              =0.01). Twenty-two of 45 study patients responded to CRT, with a reduction of left ventricular end-systolic volume index &gt;15%. Compared with nonresponders, responders had a higher delayed H\/M ratio (2.11 versus 1.48;\n              <jats:italic>P<\/jats:italic>\n              =0.003) and lower H\/M washout rate (37% versus 62%;\n              <jats:italic>P<\/jats:italic>\n              =0.003) at baseline.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>CRT improved sympathetic function. Cardiac sympathetic reserve may be a marker for the reversibility of failing myocardial function.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.110.959858","type":"journal-article","created":{"date-parts":[[2011,3,19]],"date-time":"2011-03-19T04:13:01Z","timestamp":1300507981000},"page":"339-344","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":50,"title":["Cardiac Sympathetic Reserve and Response to Cardiac Resynchronization Therapy"],"prefix":"10.1161","volume":"4","author":[{"given":"Yong-Mei","family":"Cha","sequence":"first","affiliation":[{"name":"From the Division of Cardiovascular Diseases (Y.-M.C., P.C., J.K.O., C.M., D.L.H., R.F.R., S.J.A., T.L.W., C.M.D.), the Department of Radiology, (B.J.K.), and the Division of Biomedical Statistics and Informatics (D.O.H., R.M.H.), Mayo Clinic, Rochester, MN; the Department of Cardiology (Y.-X.D., Y.-z.Y.), the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China; and the Krannert Institute of Cardiology (Y.Z., P.-S.C.), Indiana University School of Medicine, Indianapolis, IN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panithaya","family":"Chareonthaitawee","sequence":"additional","affiliation":[{"name":"From the Division of Cardiovascular Diseases (Y.-M.C., P.C., J.K.O., C.M., D.L.H., R.F.R., S.J.A., T.L.W., C.M.D.), the Department of Radiology, (B.J.K.), and the Division of Biomedical Statistics and Informatics (D.O.H., R.M.H.), Mayo Clinic, Rochester, MN; the Department of Cardiology (Y.-X.D., Y.-z.Y.), the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China; and the Krannert Institute of Cardiology (Y.Z., P.-S.C.), Indiana University School of Medicine, Indianapolis, IN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying-Xue","family":"Dong","sequence":"additional","affiliation":[{"name":"From the Division of Cardiovascular Diseases (Y.-M.C., P.C., J.K.O., C.M., D.L.H., R.F.R., S.J.A., T.L.W., C.M.D.), the Department of Radiology, (B.J.K.), and the Division of Biomedical Statistics and Informatics (D.O.H., R.M.H.), Mayo Clinic, Rochester, MN; the Department of Cardiology (Y.-X.D., Y.-z.Y.), the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China; and the Krannert Institute of Cardiology (Y.Z., P.-S.C.), Indiana University School of Medicine, Indianapolis, IN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley J.","family":"Kemp","sequence":"additional","affiliation":[{"name":"From the Division of Cardiovascular Diseases (Y.-M.C., P.C., J.K.O., C.M., D.L.H., R.F.R., S.J.A., T.L.W., C.M.D.), the Department of Radiology, (B.J.K.), and the Division of Biomedical Statistics and Informatics (D.O.H., R.M.H.), Mayo Clinic, Rochester, MN; the Department of Cardiology (Y.-X.D., Y.-z.Y.), the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China; and the Krannert Institute of Cardiology (Y.Z., P.-S.C.), Indiana University School of Medicine, Indianapolis, IN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae K.","family":"Oh","sequence":"additional","affiliation":[{"name":"From the Division of Cardiovascular Diseases (Y.-M.C., P.C., J.K.O., C.M., D.L.H., R.F.R., S.J.A., T.L.W., C.M.D.), the Department of Radiology, (B.J.K.), and the Division of Biomedical Statistics and Informatics (D.O.H., R.M.H.), Mayo Clinic, Rochester, MN; the Department of Cardiology (Y.-X.D., Y.-z.Y.), the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China; and the Krannert Institute of Cardiology (Y.Z., P.-S.C.), Indiana University School of Medicine, Indianapolis, IN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chinami","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"From the Division of Cardiovascular Diseases (Y.-M.C., P.C., J.K.O., C.M., D.L.H., R.F.R., S.J.A., T.L.W., C.M.D.), the Department of Radiology, (B.J.K.), and the Division of Biomedical Statistics and Informatics (D.O.H., R.M.H.), Mayo Clinic, Rochester, MN; the Department of Cardiology (Y.-X.D., Y.-z.Y.), the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China; and the Krannert Institute of Cardiology (Y.Z., P.-S.C.), Indiana University School of Medicine, Indianapolis, IN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David L.","family":"Hayes","sequence":"additional","affiliation":[{"name":"From the Division of Cardiovascular Diseases (Y.-M.C., P.C., J.K.O., C.M., D.L.H., R.F.R., S.J.A., T.L.W., C.M.D.), the Department of Radiology, (B.J.K.), and the Division of Biomedical Statistics and Informatics (D.O.H., R.M.H.), Mayo Clinic, Rochester, MN; the Department of Cardiology (Y.-X.D., Y.-z.Y.), the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China; and the Krannert Institute of Cardiology (Y.Z., P.-S.C.), Indiana University School of Medicine, Indianapolis, IN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert F.","family":"Rea","sequence":"additional","affiliation":[{"name":"From the Division of Cardiovascular Diseases (Y.-M.C., P.C., J.K.O., C.M., D.L.H., R.F.R., S.J.A., T.L.W., C.M.D.), the Department of Radiology, (B.J.K.), and the Division of Biomedical Statistics and Informatics (D.O.H., R.M.H.), Mayo Clinic, Rochester, MN; the Department of Cardiology (Y.-X.D., Y.-z.Y.), the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China; and the Krannert Institute of Cardiology (Y.Z., P.-S.C.), Indiana University School of Medicine, Indianapolis, IN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel J.","family":"Asirvatham","sequence":"additional","affiliation":[{"name":"From the Division of Cardiovascular Diseases (Y.-M.C., P.C., J.K.O., C.M., D.L.H., R.F.R., S.J.A., T.L.W., C.M.D.), the Department of Radiology, (B.J.K.), and the Division of Biomedical Statistics and Informatics (D.O.H., R.M.H.), Mayo Clinic, Rochester, MN; the Department of Cardiology (Y.-X.D., Y.-z.Y.), the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China; and the Krannert Institute of Cardiology (Y.Z., P.-S.C.), Indiana University School of Medicine, Indianapolis, IN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy L.","family":"Webster","sequence":"additional","affiliation":[{"name":"From the Division of Cardiovascular Diseases (Y.-M.C., P.C., J.K.O., C.M., D.L.H., R.F.R., S.J.A., T.L.W., C.M.D.), the Department of Radiology, (B.J.K.), and the Division of Biomedical Statistics and Informatics (D.O.H., R.M.H.), Mayo Clinic, Rochester, MN; the Department of Cardiology (Y.-X.D., Y.-z.Y.), the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China; and the Krannert Institute of Cardiology (Y.Z., P.-S.C.), Indiana University School of Medicine, Indianapolis, IN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Connie M.","family":"Dalzell","sequence":"additional","affiliation":[{"name":"From the Division of Cardiovascular Diseases (Y.-M.C., P.C., J.K.O., C.M., D.L.H., R.F.R., S.J.A., T.L.W., C.M.D.), the Department of Radiology, (B.J.K.), and the Division of Biomedical Statistics and Informatics (D.O.H., R.M.H.), Mayo Clinic, Rochester, MN; the Department of Cardiology (Y.-X.D., Y.-z.Y.), the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China; and the Krannert Institute of Cardiology (Y.Z., P.-S.C.), Indiana University School of Medicine, Indianapolis, IN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David O.","family":"Hodge","sequence":"additional","affiliation":[{"name":"From the Division of Cardiovascular Diseases (Y.-M.C., P.C., J.K.O., C.M., D.L.H., R.F.R., S.J.A., T.L.W., C.M.D.), the Department of Radiology, (B.J.K.), and the Division of Biomedical Statistics and Informatics (D.O.H., R.M.H.), Mayo Clinic, Rochester, MN; the Department of Cardiology (Y.-X.D., Y.-z.Y.), the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China; and the Krannert Institute of Cardiology (Y.Z., P.-S.C.), Indiana University School of Medicine, Indianapolis, IN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Regina M.","family":"Herges","sequence":"additional","affiliation":[{"name":"From the Division of Cardiovascular Diseases (Y.-M.C., P.C., J.K.O., C.M., D.L.H., R.F.R., S.J.A., T.L.W., C.M.D.), the Department of Radiology, (B.J.K.), and the Division of Biomedical Statistics and Informatics (D.O.H., R.M.H.), Mayo Clinic, Rochester, MN; the Department of Cardiology (Y.-X.D., Y.-z.Y.), the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China; and the Krannert Institute of Cardiology (Y.Z., P.-S.C.), Indiana University School of Medicine, Indianapolis, 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