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Updated: Dec 10, 2025
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Invasive Hemodynamic Monitoring of Aortic and Pulmonary Artery Hemodynamics in a Large Animal Model of ARDS
Published on: November 26, 2018
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Correlation between cardiac resynchronization response and pulmonary artery hemodynamic parameters
Jiangjin Li1,2, Zhiyong Qian3, Henghao Qiu3
1Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029. ljh197202@sina.com.
Summary
Cardiac resynchronization therapy (CRT) improves outcomes in heart failure patients. Achieving left ventricular reverse remodeling (LVRR) and clinical response with CRT indicates a good prognosis, while clinical response alone offers a better outlook than no response.
Area of Science:
- Cardiology
- Heart Failure Management
- Medical Device Therapy
Background:
- Chronic heart failure (CHF) patients often exhibit impaired cardiac function and pulmonary hypertension.
- Cardiac resynchronization therapy (CRT) is a treatment option for select CHF patients.
- Evaluating CRT response and its impact on pulmonary hemodynamics is crucial for prognosis.
Purpose of the Study:
- To assess the response to CRT in heart failure patients.
- To investigate the correlation between CRT response and pulmonary artery hemodynamic parameters.
- To analyze the prognostic implications of CRT response in relation to remodeling and clinical outcomes.
Main Methods:
- Patients with CHF indicated for CRT were enrolled, with assessments before and 6 months after implantation.
- Echocardiography measured left ventricular end-systolic volume (LVESV) for left ventricular reverse remodeling (LVRR).
- Right heart catheterization measured mean pulmonary artery pressure (mPAP), pulmonary artery systolic pressure (PASP), and pulmonary vascular resistance (PVR).
- Patients were grouped based on LVRR and clinical response (NYHA classification improvement).
- Kaplan-Meier survival analysis assessed mortality and composite endpoint events.
Main Results:
- Of 45 patients, 68.89% achieved both LVRR and clinical response (Group A), 17.78% had clinical response without LVRR (Group B), and 13.33% had neither (Group C).
- Group A showed significant improvements in cardiac function, echocardiographic, and pulmonary hemodynamic parameters post-CRT (P<0.05).
- Group B demonstrated significant improvements in NYHA classification and pulmonary hemodynamics, but not echocardiographic parameters.
- Group C showed no significant changes in any measured parameters.
- Groups A and B had significantly lower all-cause mortality and composite endpoint events compared to Group C (P=0.005 and P=0.001, respectively).
Conclusions:
- Patients achieving both LVRR and clinical response after CRT exhibit a favorable prognosis.
- Clinical response alone, without LVRR, is associated with a better prognosis than no response, potentially linked to improved pulmonary hemodynamics.
- CRT response, particularly LVRR, is a significant predictor of long-term outcomes in heart failure patients.
