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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

Maximum derivative of left ventricular pressure predicts cardiac mortality after cardiac resynchronization therapy

Hirohiko Suzuki1, Masayuki Shimano, Yukihiko Yoshida

  • 1Department of Cardiology, Nagoya University, Japan.

Clinical Cardiology
|December 25, 2010
PubMed

Insights

Lower basal left ventricular pressure (LV dP/dt(max)) and longer isovolemic LV pressure half-time (T½) predict poor outcomes in cardiac resynchronization therapy (CRT) patients. These hemodynamic measures can guide long-term prognosis assessment.

Area of Science:

  • Cardiology
  • Heart Failure Management
  • Medical Device Technology

Background:

  • Cardiac resynchronization therapy (CRT) improves cardiac performance but not always survival in advanced heart failure.
  • Prognostic indicators for CRT effectiveness in advanced heart failure remain crucial.

Purpose of the Study:

  • To investigate the association between hemodynamic parameters and long-term prognosis in patients with advanced heart failure undergoing CRT.
  • To identify specific hemodynamic markers that predict cardiac mortality or heart failure hospitalization post-CRT.

Main Methods:

  • Sixty-eight patients with advanced heart failure received CRT devices.
  • Hemodynamic studies measured parameters with CRT on and off, including LV dP/dt(max) and T½.
  • Multivariate Cox regression and Kaplan-Meier analyses assessed long-term outcomes (34.9 ± 17.6 months).

Main Results:

  • CRT significantly improved LV dP/dt(max) and QRS duration.
  • Basal LV dP/dt(max) and T½, not their percentage change, independently predicted cardiac mortality or heart failure hospitalization.
  • Patients with the lowest basal LV dP/dt(max) or longest basal T½ had significantly higher adverse event rates.

Conclusions:

  • Lower basal LV dP/dt(max) and longer basal T½ are independent predictors of adverse cardiac events in CRT recipients.
  • Assessing basal LV dP/dt(max) and T½ provides valuable prognostic information for long-term outcomes after CRT.
Abstract

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