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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Effect of cardiac resynchronization therapy on diastolic dysfunction as assessed by transthoracic two-dimensional

Bharat K Kantharia1, Hari P Joshi, Raghunandan Dudda-Subramanya

  • 1Department of Internal Medicine, Ohio State University Medical Center, Columbus, OH 43210, USA. bkantharia@yahoo.com

Congestive Heart Failure (Greenwich, Conn.)
|August 9, 2006
PubMed

Insights

Cardiac resynchronization therapy (CRT) improves heart function by enhancing diastolic function, particularly in patients without mitral regurgitation. This therapy positively impacts left ventricular diastolic parameters, suggesting broader benefits beyond electrical dyssynchrony.

Area of Science:

  • Cardiology
  • Echocardiography
  • Heart Failure Management

Background:

  • Cardiac resynchronization therapy (CRT) is established for improving outcomes in patients with left ventricular systolic dysfunction and electrical dyssynchrony.
  • Diastolic dysfunction may play a significant role in the benefits observed with CRT.

Purpose of the Study:

  • To evaluate the impact of CRT on left ventricular diastolic function using echocardiographic parameters.
  • To assess changes in the E/A ratio and mitral valve deceleration time following CRT implantation.

Main Methods:

  • Retrospective analysis of 13 patients (mean age 62 years) who underwent CRT.
  • Measurement of E/A ratio and mitral valve deceleration time pre- and post-CRT.
  • Subgroup analysis excluding patients with mitral regurgitation.

Main Results:

  • Overall, CRT showed a trend towards improved E/A ratio (1.17 to 1.49) and mitral valve deceleration time (178 to 228 ms), though not statistically significant (p=ns, p=0.054).
  • In patients without mitral regurgitation, a significant increase in E/A ratio was observed (1.22 to 1.86, p=0.025).
  • No significant change in mitral valve deceleration time was noted in the subgroup without mitral regurgitation.

Conclusions:

  • CRT may improve diastolic dysfunction in patients with systolic dysfunction and electrical dyssynchrony.
  • The E/A ratio appears to be a sensitive indicator of diastolic improvement post-CRT, especially in the absence of mitral regurgitation.
  • Routine echocardiography can help assess CRT's effects on diastolic function.

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