Improvement of Left Ventricular Function After Cardiac Resynchronization Therapy Is Predicted by Tissue Doppler Imaging Echocardiography
- 2 March 2004
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 109 (8), 978-983
- https://doi.org/10.1161/01.cir.0000116765.43251.d7
Abstract
Background— Cardiac resynchronization therapy was shown to reverse left ventricular (LV) remodeling in patients with congestive heart failure (CHF). However, the prediction of benefit is controversial. We aimed to investigate predictive factors of LV functional recovery and reversed remodeling after biventricular pacing. Methods and Results— Forty-nine consecutive patients with CHF and a wide QRS complex (182±32 ms) were studied by echocardiography before resynchronization. Intraventricular and interventricular asynchrony and their combination were assessed by pulsed-wave tissue Doppler imaging from measurements of regional electromechanical coupling times in basal segments of the right and left ventricle. At 6-month follow-up, responders were defined by a relative increase in LV ejection fraction ≥25% compared with baseline (n=27). Receiver operating curve analysis revealed the degree of intraventricular asynchrony (area under the curve=0.77), interventricular asynchrony (area under the curve=0.69), and their combination (area under the curve=0.84) as the best predictors of functional recovery after resynchronization. In addition, the degree of intraventricular and interventricular asynchrony correlated significantly with the improvement of LV ejection fraction (r=0.73, Pr=−0.59, Pr=−0.48, PConclusions— In patients with CHF, the degree of intraventricular and interventricular asynchrony and their combination are the best predictive factors of LV functional recovery and reversed remodeling after cardiac resynchronization therapy.Keywords
This publication has 28 references indexed in Scilit:
- Cardiac Resynchronization in Chronic Heart FailureNew England Journal of Medicine, 2002
- Impact of cardiac resynchronization therapy using hemodynamically optimized pacing on left ventricular remodeling in patients with congestive heart failure and ventricular conduction disturbances11The PAcing THerapies in Congestive Heart Failure (PATH-CHF) study was supported by a grant from the Guidant Corporation (St. Paul, Minnesota). Drs. Pochet, Salo, Kramer and Spinelli have corporate appointments with Guidant Corp.Journal of the American College of Cardiology, 2001
- Effects of Multisite Biventricular Pacing in Patients with Heart Failure and Intraventricular Conduction DelayNew England Journal of Medicine, 2001
- Permanent Left Ventricular Pacing With Transvenous Leads Inserted Into The Coronary VeinsPacing and Clinical Electrophysiology, 1998
- Persistence of Restrictive Left Ventricular Filling Pattern in Dilated Cardiomyopathy: An Ominous Prognostic SignJournal of the American College of Cardiology, 1997
- Myocardial wall velocity assessment by pulsed Doppler tissue imaging: Characteristic findings in normal subjectsAmerican Heart Journal, 1996
- Carvedilol improves left ventricular function and symptoms in chronic heart failure: A double-blind randomized studyJournal of the American College of Cardiology, 1995
- Suppression of left ventricular early diastolic filling by long axis asynchrony.Heart, 1995
- Systolic and diastolic dysfunction in patients with clinical diagnosis of dilated cardiomyopathy. Relation to symptoms and prognosis.Circulation, 1994
- Effects of short- and long-term carvedilol administration on rest and exercise hemodynamic variables, exercise capacity and clinical conditions in patients with idiopathic dilated cardiomyopathyJournal of the American College of Cardiology, 1994