{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T13:50:22Z","timestamp":1791121822906,"version":"4.1.0"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2002,1,29]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>\n                <jats:bold>\n                  <jats:italic>Background<\/jats:italic>\n                  \u2014\n                <\/jats:bold>\n              <\/jats:italic>\n            <\/jats:bold>\n            Biventricular pacing has been proposed to improve symptoms and exercise capacity in patients with advanced heart failure and wide electrocardiographic wave complexes. This study investigated the effect of biventricular pacing on reverse remodeling and the underlying mechanisms.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>\n                <jats:bold>\n                  <jats:italic>Methods and Results<\/jats:italic>\n                  \u2014\n                <\/jats:bold>\n              <\/jats:italic>\n            <\/jats:bold>\n            Twenty-five patients with NYHA class III to IV heart failure and electrocardiographic wave complex duration &gt;140 ms receiving biventricular pacing therapy were assessed serially up to 3 months after pacing and when pacing was withheld for 4 weeks. Tissue Doppler echocardiography was performed using a 6-basal, 6-mid segmental model to assess the time to peak sustained systolic contraction (T\n            <jats:sub>S<\/jats:sub>\n            ). There was significant improvement of ejection fraction, dP\/dt, and myocardial performance index; decrease in mitral regurgitation, left ventricular (LV) end-diastolic (205\u00b168 versus 168\u00b167 mL,\n            <jats:italic>P<\/jats:italic>\n            &lt;0.01) and end-systolic volume (162\u00b154 versus 122\u00b142 mL,\n            <jats:italic>P<\/jats:italic>\n            &lt;0.01); and improved 6-minute hall-walk distance and quality of life score after pacing for 3 months. The mechanisms of benefits were as follows: (1) improved LV synchrony, as evident by homogeneous delay of T\n            <jats:sub>S<\/jats:sub>\n            to a timing close to the latest (usually the lateral) segment abolishing the intersegmental difference in T\n            <jats:sub>S<\/jats:sub>\n            and decreasing the standard deviation of T\n            <jats:sub>S<\/jats:sub>\n            within the left ventricle (37.7\u00b110.9 versus 29.3\u00b18.3 ms,\n            <jats:italic>P<\/jats:italic>\n            &lt;0.05); (2) improved interventricular synchrony; and (3) shortened isovolumic contraction time (122\u00b157 versus 82\u00b136 ms,\n            <jats:italic>P<\/jats:italic>\n            &lt;0.05) but increased diastolic filling time. These benefits are pacing dependent, because withholding the pacing resulted in varying speeds in the loss of cardiac improvements.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>\n                <jats:bold>\n                  <jats:italic>Conclusions<\/jats:italic>\n                  \u2014\n                <\/jats:bold>\n              <\/jats:italic>\n            <\/jats:bold>\n            Biventricular pacing reverses LV remodeling and improves cardiac function. Improvement of LV mechanical synchrony seems to be the predominant mechanism.\n          <\/jats:p>","DOI":"10.1161\/hc0402.102623","type":"journal-article","created":{"date-parts":[[2002,7,28]],"date-time":"2002-07-28T23:16:07Z","timestamp":1027898167000},"page":"438-445","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":863,"title":["Tissue Doppler Echocardiographic Evidence of Reverse Remodeling and Improved Synchronicity by Simultaneously Delaying Regional Contraction After Biventricular Pacing Therapy in Heart Failure"],"prefix":"10.1161","volume":"105","author":[{"given":"Cheuk-Man","family":"Yu","sequence":"first","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine, Queen Mary Hospital (C.-M.Y., M.-O.T., H.L., S.-L.K., Y.-M.L., C.-P.L.) and Division of Cardiology, Department of Medicine, Grantham Hospital (E.C., K.F.), The University of Hong Kong; Division of Cardiology, Department of Medicine, Prince of Wales Hospital (J.E.S., W.-H.F.), The Chinese University of Hong Kong; and Medtronic Inc (M.R.S.H.), Minneapolis, Minn."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Chau","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine, Queen Mary Hospital (C.-M.Y., M.-O.T., H.L., S.-L.K., Y.-M.L., C.-P.L.) and Division of Cardiology, Department of Medicine, Grantham Hospital (E.C., K.F.), The University of Hong Kong; Division of Cardiology, Department of Medicine, Prince of Wales Hospital (J.E.S., W.-H.F.), The Chinese University of Hong Kong; and Medtronic Inc (M.R.S.H.), Minneapolis, Minn."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John E.","family":"Sanderson","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine, Queen Mary Hospital (C.-M.Y., M.-O.T., H.L., S.-L.K., Y.-M.L., C.-P.L.) and Division of Cardiology, Department of Medicine, Grantham Hospital (E.C., K.F.), The University of Hong Kong; Division of Cardiology, Department of Medicine, Prince of Wales Hospital (J.E.S., W.-H.F.), The Chinese University of Hong Kong; and Medtronic Inc (M.R.S.H.), Minneapolis, Minn."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Fan","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine, Queen Mary Hospital (C.-M.Y., M.-O.T., H.L., S.-L.K., Y.-M.L., C.-P.L.) and Division of Cardiology, Department of Medicine, Grantham Hospital (E.C., K.F.), The University of Hong Kong; Division of Cardiology, Department of Medicine, Prince of Wales Hospital (J.E.S., W.-H.F.), The Chinese University of Hong Kong; and Medtronic Inc (M.R.S.H.), Minneapolis, Minn."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Man-Oi","family":"Tang","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine, Queen Mary Hospital (C.-M.Y., M.-O.T., H.L., S.-L.K., Y.-M.L., C.-P.L.) and Division of Cardiology, Department of Medicine, Grantham Hospital (E.C., K.F.), The University of Hong Kong; Division of Cardiology, Department of Medicine, Prince of Wales Hospital (J.E.S., W.-H.F.), The Chinese University of Hong Kong; and Medtronic Inc (M.R.S.H.), Minneapolis, Minn."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wing-Hong","family":"Fung","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine, Queen Mary Hospital (C.-M.Y., M.-O.T., H.L., S.-L.K., Y.-M.L., C.-P.L.) and Division of Cardiology, Department of Medicine, Grantham Hospital (E.C., K.F.), The University of Hong Kong; Division of Cardiology, Department of Medicine, Prince of Wales Hospital (J.E.S., W.-H.F.), The Chinese University of Hong Kong; and Medtronic Inc (M.R.S.H.), Minneapolis, Minn."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Lin","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine, Queen Mary Hospital (C.-M.Y., M.-O.T., H.L., S.-L.K., Y.-M.L., C.-P.L.) and Division of Cardiology, Department of Medicine, Grantham Hospital (E.C., K.F.), The University of Hong Kong; Division of Cardiology, Department of Medicine, Prince of Wales Hospital (J.E.S., W.-H.F.), The Chinese University of Hong Kong; and Medtronic Inc (M.R.S.H.), Minneapolis, Minn."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun-Ling","family":"Kong","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine, Queen Mary Hospital (C.-M.Y., M.-O.T., H.L., S.-L.K., Y.-M.L., C.-P.L.) and Division of Cardiology, Department of Medicine, Grantham Hospital (E.C., K.F.), The University of Hong Kong; Division of Cardiology, Department of Medicine, Prince of Wales Hospital (J.E.S., W.-H.F.), The Chinese University of Hong Kong; and Medtronic Inc (M.R.S.H.), Minneapolis, Minn."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yui-Ming","family":"Lam","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine, Queen Mary Hospital (C.-M.Y., M.-O.T., H.L., S.-L.K., Y.-M.L., C.-P.L.) and Division of Cardiology, Department of Medicine, Grantham Hospital (E.C., K.F.), The University of Hong Kong; Division of Cardiology, Department of Medicine, Prince of Wales Hospital (J.E.S., W.-H.F.), The Chinese University of Hong Kong; and Medtronic Inc (M.R.S.H.), Minneapolis, Minn."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.S.","family":"Hill","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine, Queen Mary Hospital (C.-M.Y., M.-O.T., H.L., S.-L.K., Y.-M.L., C.-P.L.) and Division of Cardiology, Department of Medicine, Grantham Hospital (E.C., K.F.), The University of Hong Kong; Division of Cardiology, Department of Medicine, Prince of Wales Hospital (J.E.S., W.-H.F.), The Chinese University of Hong Kong; and Medtronic Inc (M.R.S.H.), Minneapolis, Minn."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chu-Pak","family":"Lau","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine, Queen Mary Hospital (C.-M.Y., M.-O.T., H.L., S.-L.K., Y.-M.L., C.-P.L.) and Division of Cardiology, Department of Medicine, Grantham Hospital (E.C., K.F.), The University of Hong Kong; Division of Cardiology, Department of Medicine, Prince of Wales Hospital (J.E.S., W.-H.F.), The Chinese University of Hong Kong; 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