Pre-implant right ventricular function might be an important predictor of the response to cardiac resynchronization therapy

Cardiovascular Ultrasound

Research

Peter Henriksson¹  Magnus Edner¹  Margareta Ring² 

[1] Karolinska Institutet, Division of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden;Karolinska Institutet, Division of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden;Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden;

关键词: Right Ventricular;    Cardiac Resynchronization Therapy;    Tissue Doppler Image;    Right Ventricular Function;    Right Ventricular Dysfunction;   

DOI  :  10.1186/1476-7120-9-28

 received in 2011-06-06, accepted in 2011-10-26,  发布年份 2011

来源: Springer

【 摘 要 】

ObjectiveCardiac resynchronization therapy is proven efficacious in patients with heart failure (HF). Presence of biventricular HF is associated with a worse prognosis than having only left ventricular (LV) HF and pacing might deteriorate heart function. The aim of the study was to assess a possible significance of right ventricular (RV) pre-implant systolic function to predict response to CRT.DesignWe studied 22 HF-patients aged 72 ± 11 years, QRS-duration 155 ± 20 ms and with an LV ejection fraction (EF) of 26 ± 6% before and four weeks after receiving a CRT-device.ResultsThere were no changes in LV diameters or end systolic volume (ESV) during the study. However, end diastolic volume (EDV) decreased from 226 ± 71 to 211 ± 64 ml (p = 0.02) and systolic maximal velocities (SMV) increased from 2.2 ± 0.4 to 2.6 ± 0.9 cm/s (p = 0.04). Pre-implant RV-SMV (6.2 ± 2.6 cm/s) predicted postoperative increase in LV contractility, p = 0.032.ConclusionsPre-implant decreased RV systolic function might be an important way to predict a poor response to CRT implicating that other treatments should be considered. Furthermore we found that 3D- echocardiography and Tissue Doppler Imaging were feasible to detect short-term changes in LV function.

【 授权许可】

CC BY   
© Edner et al; licensee BioMed Central Ltd. 2011