The effect of cardiac resynchronization therapy on arterial stiffness and central hemodynamic parameters
Metin Coksevim1, Murat Akcay1, Serkan Yuksel2
1School of Medicine Department of Cardiology Ondokuz Mayis University Samsun Turkey.
Insights
Cardiac resynchronization therapy (CRT) improves hemodynamic function and arterial stiffness in heart failure patients. These positive changes correlate with better clinical outcomes following CRT.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Devices
Background:
- Cardiac resynchronization therapy (CRT) is a key treatment for heart failure with reduced ejection fraction (HFrEF), reducing morbidity and mortality.
- Investigating CRT's impact on hemodynamic and arterial stiffness parameters using noninvasive methods is crucial for understanding treatment efficacy.
Purpose of the Study:
- To assess the effects of CRT on hemodynamic and arterial stiffness parameters.
- To determine the correlation between post-CRT parameter changes and clinical response.
Main Methods:
- 46 HFrEF patients undergoing CRT implantation were studied.
- Hemodynamic and arterial stiffness parameters were measured using an arteriograph before and at least three months after CRT.
- Clinical and demographic data were collected pre-implantation.
Main Results:
- Post-CRT, significant increases were observed in systolic blood pressure (SBP), central SBP (cSBP), cardiac output (CO), stroke volume, and pulse wave velocity (PWV).
- These hemodynamic and arterial stiffness improvements were significantly more pronounced in patients with a positive clinical response to CRT.
- Nonresponder patients did not exhibit similar increases in these measured parameters.
Conclusions:
- CRT significantly enhances SBP, CO, and PWV in HFrEF patients.
- The observed modest increases in these parameters are associated with favorable clinical outcomes, highlighting their role as indicators of CRT effectiveness.
Introduction:
Cardiac resynchronization therapy (CRT) is a device-based method of treatment which decreases morbidity and mortality in heart failure with reduced ejection fraction (HFrEF). This study was aimed to investigate the effects of CRT on hemodynamic and arterial stiffness parameters evaluated by noninvasive method, and determine whether there is a correlation between the changes after CRT in these parameters and the clinical response to CRT or not.
Methods:
The study included 46 patients with HFrEF who were planned to undergo CRT implantation. Before the CRT implantation, clinical and demographic data were recorded from all patients. Hemodynamic and arterial stiffness parameters were measured oscillometrically by an arteriograph before CRT implantation. The patients were re-evaluated minimum three months after CRT; the above-mentioned parameters were measured again and compared to the pre-CRT period.
Results:
Compared to the period before CRT, mean systolic blood pressure (SBP) (116.8 ± 19.1 mm Hg vs 127.7 ± 20.9 mm Hg, P = .005), central SBP (cSBP) (106.2 ± 17.3 mm Hg vs 116.8 ± 18.7 mm Hg, P = .015), cardiac output (CO) (4.6 ± 0.8 lt/min vs 5.1 ± 0.8 lt/min, P = .002), stroke volume (65.6 ± 16.3 mL vs 72.0 ± 14.9 mL), and pulse wave velocity (PWV) (10 ± 1.6 m/sec vs 10.4 ± 1.8 m/sec, P = .004) increased significantly in post-CRT period. In addition, the same parameters were significantly increased post-CRT period in patients with clinical response. However, there was not any similar increase in nonresponder patients.
Conclusion:
This study demonstrated that SBP, CO, and PWV increased significantly after CRT. The modest increases in these parameters were observed to be associated with positive clinical outcomes.
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