Background: Cardiac resynchronization therapy (CRT) is currently used for treating patients with heart failure (HF) and aim to test intraventricular dyssynchrony (IVD). Whether interventricular mechanical dyssynchrony can also predict a favorable response. Methods: 37 patients (mean age 68 ± 8 years, 27 males) with dilated cardiomyopathy, NYHA class-IV, LV ejection fraction (EF) = 35%, QRS > 120 ms were studied before CRT, after 3 and 6 months (m). Two indexes of IVD were calculated: the Qa-Qp delay at the onset (Qa-Qponset) and peak (Qa-Qppeak) of the conventional PW Doppler curves of the pulmonary and aortic systolic flow velocities. Responders were defined at month 6 by ≥ 20% EF increase or ≥ 15% end-systolic volume decrease with respect to baseline (Bs). Results: Both Qa-Qponset and Qa-Qppeak significantly decreased over time with CRT. This was due to an increase of the Qp component without significant variation of the Qa component. However, both parameters were not able to differentiate CRT responders from non-responders. Conclusions: Ultrasound evaluation of IVD does not provide significant additional information respect to the evaluation of left intraventricular dyssynchrony for prediction of CRT response.
Interventricular dyssynchrony does not identify CRT responders in patients with heart failure
CECONI, Claudio;
2007
Abstract
Background: Cardiac resynchronization therapy (CRT) is currently used for treating patients with heart failure (HF) and aim to test intraventricular dyssynchrony (IVD). Whether interventricular mechanical dyssynchrony can also predict a favorable response. Methods: 37 patients (mean age 68 ± 8 years, 27 males) with dilated cardiomyopathy, NYHA class-IV, LV ejection fraction (EF) = 35%, QRS > 120 ms were studied before CRT, after 3 and 6 months (m). Two indexes of IVD were calculated: the Qa-Qp delay at the onset (Qa-Qponset) and peak (Qa-Qppeak) of the conventional PW Doppler curves of the pulmonary and aortic systolic flow velocities. Responders were defined at month 6 by ≥ 20% EF increase or ≥ 15% end-systolic volume decrease with respect to baseline (Bs). Results: Both Qa-Qponset and Qa-Qppeak significantly decreased over time with CRT. This was due to an increase of the Qp component without significant variation of the Qa component. However, both parameters were not able to differentiate CRT responders from non-responders. Conclusions: Ultrasound evaluation of IVD does not provide significant additional information respect to the evaluation of left intraventricular dyssynchrony for prediction of CRT response.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
