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Updated: Jul 2, 2026
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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
Endothelial dysfunction in heart failure identifies responders to cardiac resynchronization therapy
Joseph G Akar1, M Obadah Al-Chekakie, Tyler Fugate
1Department of Medicine, Division of Cardiology, Loyola University Medical Center, Maywood, Illinois 60153, USA. jakar@lumc.edu
Heart Rhythm
|September 9, 2008
Summary
Endothelial dysfunction predicts response to cardiac resynchronization therapy (CRT). Assessing endothelial function may improve patient selection for CRT, enhancing heart failure outcomes.
Area of Science:
- Cardiology
- Vascular Biology
- Heart Failure Management
Background:
- Endothelial dysfunction is linked to higher heart failure mortality.
- Cardiac resynchronization therapy (CRT) improves heart failure outcomes but identifying responders remains challenging.
Purpose of the Study:
- To investigate if endothelial dysfunction can predict patient response to CRT.
- To assess the utility of endothelial function testing in CRT selection.
Main Methods:
- Measured brachial artery flow-mediated dilation (endothelial function) pre-CRT and 90 days post-CRT in 33 heart failure patients.
- Analyzed correlation between baseline endothelial function and CRT response, including changes in LVEF, 6-minute walk distance, and quality of life.
Main Results:
- 58% of patients responded to CRT.
- Non-responders had significantly poorer baseline flow-mediated dilation (8.6%) compared to responders (4.6%).
- Baseline endothelial dysfunction correlated with reduced functional capacity and predicted increased likelihood of CRT response, independent of other factors.
Conclusions:
- Endothelial dysfunction is an independent predictor of CRT response.
- Incorporating endothelial function assessment into current criteria could enhance the identification of CRT responders.
- Improved identification of CRT responders may lead to better heart failure management.
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