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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

Cardiac resynchronization therapy decreases the mitral coaptation point displacement in heart failure patients

Stefanos E Karagiannis1, Themistoklis Maounis, George D Athanassopoulos

  • 11st Cardiology Department, Onassis Cardiac Surgery Center, Athens Greece. stefkarag@yahoo.gr

Hellenic Journal of Cardiology : HJC = Hellenike Kardiologike Epitheorese
|August 11, 2006
PubMed

Insights

Cardiac resynchronization therapy (CRT) significantly reduced mitral leaflet coaptation point (CPMA) displacement in patients with heart failure. This simple measurement shows CRT

Area of Science:

  • Cardiology
  • Echocardiography
  • Heart Failure Management

Background:

  • Left ventricular (LV) dysfunction in heart failure (HF) causes mitral leaflet coaptation point (CPMA) displacement towards the LV apex.
  • Cardiac resynchronization therapy (CRT) is an established treatment for HF, but its acute effects require simple assessment methods.

Purpose of the Study:

  • To evaluate the mitral leaflet coaptation point (CPMA) as a simple index for assessing the acute effects of cardiac resynchronization therapy (CRT).
  • To determine the impact of CRT on CPMA in patients with severe left ventricular (LV) systolic dysfunction and dilatation.

Main Methods:

  • Twenty patients with NYHA III-IV congestive heart failure (CHF) and LV ejection fraction (LVEF) of 22 ± 4% underwent echocardiography.
  • Echocardiographic parameters including LV end-diastolic diameter (LVEDD), LV end-systolic diameter (LVESD), LVEF, mitral annulus diameter (MAD), intraventricular desynchronization, and CPMA were measured with CRT off and CRT on.
  • CPMA was measured in end-systole from the apical 4-chamber view.

Main Results:

  • CRT significantly improved LV contractility and dimensions, with LVEF increasing from 24.5 ± 5.7% to 29.5 ± 5.1% (p < 0.001).
  • CPMA decreased significantly from 11.3 ± 2 mm to 9.1 ± 1.8 mm (p < 0.001) after CRT.
  • CRT also reduced MAD and intraventricular desynchronization, and CPMA changes correlated with LV dimensions and synchronization improvements.

Conclusions:

  • CRT is associated with significant improvement in mitral leaflet coaptation point (CPMA) and mitral annulus diameter (MAD) in patients with severe LV systolic dysfunction.
  • CPMA measurement serves as a valuable and simple index for evaluating the acute hemodynamic benefits of CRT in heart failure patients.
Abstract

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