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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
Improvement in right ventricular systolic function after cardiac resynchronization therapy correlates with left
Hakan Aksoy1, Sercan Okutucu, Kudret Aytemir
1Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Pacing and Clinical Electrophysiology : PACE
|October 2, 2010
Summary
Cardiac resynchronization therapy improves right ventricular (RV) systolic function in heart failure patients who respond to treatment. Improvement in RV function after CRT is linked to reduced left ventricular end-systolic volume.
Area of Science:
- Cardiology
- Heart Failure Management
- Echocardiography
Background:
- Cardiac resynchronization therapy (CRT) is known to enhance left ventricular (LV) systolic function in heart failure (HF) patients.
- The impact of CRT on right ventricular (RV) systolic function remains less understood.
Purpose of the Study:
- To identify echocardiographic indicators associated with improved RV systolic function following CRT.
- To explore the relationship between CRT response and changes in RV function.
Main Methods:
- Fifty-four heart failure patients with LV ejection fraction ≤ 35% and QRS duration > 120 ms underwent standard echocardiography, strain rate (SR), and tissue Doppler imaging (TDI) before and 6 months after CRT.
- Pulsed-wave TDI-derived RV systolic indices included RV systolic velocity (RV(S)), isovolumic velocity (RV(IVV)), and isovolumic acceleration (RV(IVA)).
- CRT response was defined by a ≥ 10% reduction in LV end-systolic volume (LVESV).
Main Results:
- In CRT responders (70.4%), significant improvements were observed in RV end-diastolic diameters, mid-RV strain, and mid-RV SR (P < 0.01).
- RV(S), RV(IVV), and RV(IVA) significantly increased in responders (P < 0.001 for RV(IVV) and RV(IVA)).
- No significant changes in these RV parameters were noted in non-responders. Reduction in LVESV correlated positively with improvements in RV(IVV) and RV(IVA) (r = 0.467-0.473, P = 0.001).
Conclusions:
- Right ventricular diameters and systolic indices improve post-CRT exclusively in patients who respond to therapy.
- Enhanced RV systolic performance after CRT is associated with a reduction in LVESV, highlighting a potential link between LV remodeling and RV function.
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