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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
Relationship between left ventricular dyssynchrony and reverse remodeling after cardiac resynchronization therapy.
Umut Celikyurt1, Ahmet Vural, Tayfun Sahin
1Department of Cardiology, Kocaeli University Medical Faculty, Kocaeli, Turkey. ycelikyurt@gmail.com
Clinical Cardiology
|September 14, 2011
Summary
Cardiac resynchronization therapy (CRT) improves left ventricular (LV) dyssynchrony, particularly when reverse remodeling is defined by LV end-systolic volume. Improvement in LV dyssynchrony is key for reverse remodeling but not solely sufficient for LVEF changes.
Area of Science:
- Cardiology
- Heart Failure Management
- Cardiac Electrophysiology
Background:
- Cardiac resynchronization therapy (CRT) is a standard treatment for advanced chronic heart failure.
- Pre-treatment left ventricular (LV) dyssynchrony predicts CRT response.
- The study investigates the temporal relationship between LV dyssynchrony and reverse remodeling (RR) post-CRT.
Purpose of the Study:
- To analyze the time course of LV dyssynchrony after CRT.
- To determine the association between LV dyssynchrony improvement and RR.
- To explore how different RR criteria influence this relationship.
Main Methods:
- 30 advanced heart failure patients with wide QRS and LVEF ≤35% were enrolled.
- Echocardiography with tissue Doppler imaging was performed at baseline, 1 month, and 6 months.
- Patients were classified into RR or no-remodeling groups based on LVESV decrease or LVEF increase.
Main Results:
- LV dyssynchrony improved significantly by 1 month in both groups based on LVESV decrease.
- Continued LV dyssynchrony improvement was observed in the RR group, but not the no-remodeling group.
- LV dyssynchrony improved significantly at 1 and 6 months in both groups based on LVEF increase.
Conclusions:
- LV dyssynchrony improvement is crucial for RR defined by LVESV reduction.
- RR based on LVEF increase appears independent of LV dyssynchrony improvement.
- LV dyssynchrony improvement is necessary but not sufficient to explain LVEF and LVESV changes post-CRT.
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