{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T18:54:23Z","timestamp":1768071263420,"version":"3.49.0"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2012,9,11]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Normal coronary blood flow is principally determined by a backward-traveling decompression (suction) wave in diastole. Dyssynchronous chronic heart failure may attenuate suction, because regional relaxation and contraction overlap in timing. We hypothesized that biventricular pacing, by restoring left ventricular (LV) synchronization and improving LV relaxation, might increase this suction wave, improving coronary flow.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Method and Results\u2014<\/jats:title>\n            <jats:p>\n              Ten patients with chronic heart failure (9 males; age 65\u00b112; ejection fraction 26\u00b17%) with left bundle-branch block (LBBB; QRS duration 174\u00b118 ms) were atriobiventricularly paced at 100 bpm. LV pressure was measured and wave intensity calculated from invasive coronary flow velocity and pressure, with native conduction (LBBB) and during biventricular pacing at atrioventricular (AV) delays of 40 ms, 120 ms, and separately preidentified hemodynamically optimal AV delay. In comparison with LBBB, biventricular pacing at separately preidentified hemodynamically optimal AV delay (BiV-Opt) enhanced coronary flow velocity time integral by 15% (7%\u201325%) (\n              <jats:italic>P<\/jats:italic>\n              =0.007), LV dP\/dt\n              <jats:sub>max<\/jats:sub>\n              by 15% (10%\u201321%) (\n              <jats:italic>P<\/jats:italic>\n              =0.005), and\n              <jats:sub>neg<\/jats:sub>\n              dP\/dt\n              <jats:sub>max<\/jats:sub>\n              by 17% (9%\u201322%) (\n              <jats:italic>P<\/jats:italic>\n              =0.005). The cumulative intensity of the diastolic backward decompression (suction) wave increased by 26% (18%\u201354%) (\n              <jats:italic>P<\/jats:italic>\n              =0.005). The majority of the increase in coronary flow velocity time integral occurred in diastole (69% [41%\u201384% ];\n              <jats:italic>P<\/jats:italic>\n              =0.047). The systolic compression waves also increased: forward by 36% (6%\u201349%) (\n              <jats:italic>P<\/jats:italic>\n              =0.022) and backward by 38% (20%\u201355%) (\n              <jats:italic>P<\/jats:italic>\n              =0.022). Biventricular pacing at AV delays of 120 ms generated a smaller LV dP\/dt\n              <jats:sub>max<\/jats:sub>\n              (by 12% [5%\u201323% ],\n              <jats:italic>P<\/jats:italic>\n              =0.013) and\n              <jats:sub>neg<\/jats:sub>\n              dP\/dt\n              <jats:sub>max<\/jats:sub>\n              (by 15% [8%\u201340% ];\n              <jats:italic>P<\/jats:italic>\n              =0.009) increase than BiV-Opt, against LBBB as reference; BiV-Opt and biventricular pacing at AV delays of 120 ms were not significantly different in coronary flow velocity time integral or waves. Biventricular pacing at AV delays of 40 ms was no different from LBBB.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>When biventricular pacing improves LV contraction and relaxation, it increases coronary blood flow velocity, predominantly by increasing the dominant diastolic backward decompression (suction) wave.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.111.075606","type":"journal-article","created":{"date-parts":[[2012,8,2]],"date-time":"2012-08-02T00:15:48Z","timestamp":1343866548000},"page":"1334-1344","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":39,"title":["Improvement in Coronary Blood Flow Velocity With Acute Biventricular Pacing Is Predominantly Due to an Increase in a Diastolic Backward-Travelling Decompression (Suction) Wave"],"prefix":"10.1161","volume":"126","author":[{"given":"Andreas","family":"Kyriacou","sequence":"first","affiliation":[{"name":"From the International Center for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.K., Z.I.W., S.S., P.A.P., I.W., D.L., D.W.D., N.S.P., P.KI., J.M., A.D.H., D.P.F., J.E.D.); and Research &amp; Technology, Bakken Research Center, Medtronic Inc., and Department of Physiology, CARIM, Maastricht University, Maastricht, The Netherlands (R.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary I.","family":"Whinnett","sequence":"additional","affiliation":[{"name":"From the International Center for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.K., Z.I.W., S.S., P.A.P., I.W., D.L., D.W.D., N.S.P., P.KI., J.M., A.D.H., D.P.F., J.E.D.); and Research &amp; Technology, Bakken Research Center, Medtronic Inc., and Department of Physiology, CARIM, Maastricht University, Maastricht, The Netherlands (R.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sayan","family":"Sen","sequence":"additional","affiliation":[{"name":"From the International Center for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.K., Z.I.W., S.S., P.A.P., I.W., D.L., D.W.D., N.S.P., P.KI., J.M., A.D.H., D.P.F., J.E.D.); and Research &amp; Technology, Bakken Research Center, Medtronic Inc., and Department of Physiology, CARIM, Maastricht University, Maastricht, The Netherlands (R.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Punam A.","family":"Pabari","sequence":"additional","affiliation":[{"name":"From the International Center for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.K., Z.I.W., S.S., P.A.P., I.W., D.L., D.W.D., N.S.P., P.KI., J.M., A.D.H., D.P.F., J.E.D.); and Research &amp; Technology, Bakken Research Center, Medtronic Inc., and Department of Physiology, CARIM, Maastricht University, Maastricht, The Netherlands (R.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Wright","sequence":"additional","affiliation":[{"name":"From the International Center for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.K., Z.I.W., S.S., P.A.P., I.W., D.L., D.W.D., N.S.P., P.KI., J.M., A.D.H., D.P.F., J.E.D.); and Research &amp; Technology, Bakken Research Center, Medtronic Inc., and Department of Physiology, CARIM, Maastricht University, Maastricht, The Netherlands (R.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Cornelussen","sequence":"additional","affiliation":[{"name":"From the International Center for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.K., Z.I.W., S.S., P.A.P., I.W., D.L., D.W.D., N.S.P., P.KI., J.M., A.D.H., D.P.F., J.E.D.); and Research &amp; Technology, Bakken Research Center, Medtronic Inc., and Department of Physiology, CARIM, Maastricht University, Maastricht, The Netherlands (R.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Lefroy","sequence":"additional","affiliation":[{"name":"From the International Center for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.K., Z.I.W., S.S., P.A.P., I.W., D.L., D.W.D., N.S.P., P.KI., J.M., A.D.H., D.P.F., J.E.D.); and Research &amp; Technology, Bakken Research Center, Medtronic Inc., and Department of Physiology, CARIM, Maastricht University, Maastricht, The Netherlands (R.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. Wyn","family":"Davies","sequence":"additional","affiliation":[{"name":"From the International Center for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.K., Z.I.W., S.S., P.A.P., I.W., D.L., D.W.D., N.S.P., P.KI., J.M., A.D.H., D.P.F., J.E.D.); and Research &amp; Technology, Bakken Research Center, Medtronic Inc., and Department of Physiology, CARIM, Maastricht University, Maastricht, The Netherlands (R.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas S.","family":"Peters","sequence":"additional","affiliation":[{"name":"From the International Center for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.K., Z.I.W., S.S., P.A.P., I.W., D.L., D.W.D., N.S.P., P.KI., J.M., A.D.H., D.P.F., J.E.D.); and Research &amp; Technology, Bakken Research Center, Medtronic Inc., and Department of Physiology, CARIM, Maastricht University, Maastricht, The Netherlands (R.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prapa","family":"Kanagaratnam","sequence":"additional","affiliation":[{"name":"From the International Center for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.K., Z.I.W., S.S., P.A.P., I.W., D.L., D.W.D., N.S.P., P.KI., J.M., A.D.H., D.P.F., J.E.D.); and Research &amp; Technology, Bakken Research Center, Medtronic Inc., and Department of Physiology, CARIM, Maastricht University, Maastricht, The Netherlands (R.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamil","family":"Mayet","sequence":"additional","affiliation":[{"name":"From the International Center for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.K., Z.I.W., S.S., P.A.P., I.W., D.L., D.W.D., N.S.P., P.KI., J.M., A.D.H., D.P.F., J.E.D.); and Research &amp; Technology, Bakken Research Center, Medtronic Inc., and Department of Physiology, CARIM, Maastricht University, Maastricht, The Netherlands (R.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alun D.","family":"Hughes","sequence":"additional","affiliation":[{"name":"From the International Center for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.K., Z.I.W., S.S., P.A.P., I.W., D.L., D.W.D., N.S.P., P.KI., J.M., A.D.H., D.P.F., J.E.D.); and Research &amp; Technology, Bakken Research Center, Medtronic Inc., and Department of Physiology, CARIM, Maastricht University, Maastricht, The Netherlands (R.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darrel P.","family":"Francis","sequence":"additional","affiliation":[{"name":"From the International Center for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.K., Z.I.W., S.S., P.A.P., I.W., D.L., D.W.D., N.S.P., P.KI., J.M., A.D.H., D.P.F., J.E.D.); and Research &amp; Technology, Bakken Research Center, Medtronic Inc., and Department of Physiology, CARIM, Maastricht University, Maastricht, The Netherlands (R.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin E.","family":"Davies","sequence":"additional","affiliation":[{"name":"From the International Center for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.K., Z.I.W., S.S., P.A.P., I.W., D.L., D.W.D., N.S.P., P.KI., J.M., A.D.H., D.P.F., J.E.D.); and Research &amp; Technology, Bakken Research Center, Medtronic Inc., and Department of Physiology, CARIM, Maastricht University, Maastricht, The Netherlands (R.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(98)00492-6"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)01727-8"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.99.12.1567"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/hc5001.102229"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.02.098"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.102.25.3053"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050496"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.20.2685"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013168"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200103223441202"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032423"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0906431"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009540"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi046"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejheart.2004.07.003"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.105.603050"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1115\/1.2891191"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1115\/1.2895433"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.2000.89.4.1636"},{"key":"e_1_3_4_21_2","volume-title":"ESC Congress 2008","author":"Hadjiloizou N","year":"2008","unstructured":"Hadjiloizou N, Davies JE, Baksi AJ, Malik I, Foale R, Parker K, Hughes AD, Francis DP, Mayet J. The effect of elective percutaneous coronary intervention on coronary haemodynamics and microvascular function. In: ESC Congress 2008. Munich, Germany: European Society of Cardiology; 2008. Abstract 643."},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.011916"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.087445"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eul017"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2005.080721"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2007.08.004"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2007.11.019"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2010.02933.x"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10741-010-9203-5"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","unstructured":"Francis DP. How to reliably deliver narrow individual-patient error bars for optimization of pacemaker AV or VV delay using a \u201cpick-the-highest\u201d strategy with haemodynamic measurements. Int J Cardiol. April 18 2012. doi: 10.1016\/j.ijcard.2012.03.128. http:\/\/www.sciencedirect.com\/science\/article\/pii\/S016752731200335X. Accessed August 15 2012.","DOI":"10.1016\/j.ijcard.2012.03.128"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.4236\/am.2011.212212"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.22.6.753"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.1990.70.2.247"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","unstructured":"Francis DP. How easily can omission of patients or selection amongst poorly-reproducible measurements create artificial correlations? Methods for detection and implications for observational research design in cardiology. Int J Cardiol. January 26 2012. doi: 10.1016\/j.ijcard.2011.12.018. http:\/\/www.sciencedirect.com\/science\/article\/pii\/S0167527311021784. Accessed August 15 2012.","DOI":"10.1016\/j.ijcard.2011.12.018"},{"key":"e_1_3_4_35_2","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1080\/00031305.1990.10475712","article-title":"Multiple comparison procedures: the practical solution","volume":"44","author":"Saville DJ","year":"1999","unstructured":"Saville DJ. Multiple comparison procedures: the practical solution. Am Stat. 1999;44:174\u2013180.","journal-title":"Am Stat"},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.700971"},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.1161\/circep.109.882910"},{"key":"e_1_3_4_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00068-6"},{"key":"e_1_3_4_39_2","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.1994.sp020209"},{"key":"e_1_3_4_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(76)90457-4"},{"key":"e_1_3_4_41_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.85.3.1125"},{"key":"e_1_3_4_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(97)82542-9"},{"key":"e_1_3_4_43_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.94.9.2260"},{"key":"e_1_3_4_44_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01907924"},{"key":"e_1_3_4_45_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.20683"},{"key":"e_1_3_4_46_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfr094"},{"key":"e_1_3_4_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.04.042"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.111.075606","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T06:17:55Z","timestamp":1715581075000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.111.075606"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,9,11]]},"references-count":46,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2012,9,11]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.111.075606"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.111.075606","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,9,11]]},"assertion":[{"value":"2011-10-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-07-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-08-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}