Influence of cardiac resynchronization therapy on myocardial blood flow, perfusion, and glucose metabolism

摘要

Here we report the influence of cardiac resynchronization therapy (CRT) with biventricular pacing on myocardial glucose metabolism, perfusion, and blood flow (MBF) in idiopathic dilated cardiomyopathy and left bundle branch block (LBBB). Baseline heterogeneity of glucose metabolism was homogenized by CRT whereas the influence on perfusion was less marked. Flexible regulation of gene expression of the insulin-sensitive glucose transporter GLUT-4 provides the likeliest pathophysiological explanation. Left ventricular (LV) MBF was homogeneous in LBBB and not influenced by CRT. Therefore, the beneficial effects of CRT do not require additional oxygen demand or regional reallocation of oxidative metabolism.