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Related Experiment Videos

Cardiac resynchronization therapy acutely improves diastolic function.

Alan D Waggoner1, Mitchell N Faddis, Marye J Gleva

  • 1Cardiovascular Imaging and Clinical Research Core Laboratory, Cardiovascular Division, Box 8086, Washington University School of Medicine, 660 S. Euclid Ave., St Louis, MO 63310, USA. waggonea@msnotes.wustl.edu

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|March 5, 2005
PubMed
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Cardiac resynchronization therapy (CRT) improves heart function by reducing left ventricular (LV) volumes and enhancing ejection fraction. Diastolic filling improvements and lower LV filling pressures are seen, but depend on pre-therapy filling characteristics.

Area of Science:

  • Cardiology
  • Heart Failure Management
  • Cardiac Electrophysiology

Background:

  • Cardiac resynchronization therapy (CRT) is used for severe heart failure.
  • CRT acutely improves left ventricular (LV) systolic performance and lowers filling pressures.
  • Medically-refractory heart failure patients often show benefits from CRT.

Purpose of the Study:

  • To evaluate the acute effects of CRT on LV systolic and diastolic function.
  • To assess changes in LV volumes, ejection fraction, and filling pressures post-CRT.
  • To determine if pre-CRT diastolic filling characteristics predict CRT response.

Main Methods:

  • Invasive hemodynamic and echocardiographic measurements were taken before and after CRT.
  • Key parameters included LV volumes, ejection fraction (LVEF), mitral inflow velocities (E/A), diastolic filling time (DFT), and mitral E/Em ratio.

Related Experiment Videos

  • LV filling pressures were estimated using PWD mitral E-wave/Em and E/FP ratios.

    • Main Results:

    • CRT significantly decreased LV volumes and increased LVEF immediately after therapy.
    • Mitral E-wave velocity decreased, while E-wave duration and DFT increased, indicating improved diastolic filling.
    • A significant decrease in LV filling pressure was observed, evidenced by a lower mitral E/FP ratio.

    Conclusions:

    • Acute CRT effects include reduced LV volumes, increased LVEF, and improved diastolic function with lower filling pressures.
    • LV relaxation is not significantly altered by acute CRT.
    • The degree of improvement in diastolic function is contingent upon pre-CRT LV filling characteristics, particularly the mitral E/A ratio.