AIMS: Although acute haemodynamic improvement in response to cardiac resynchronization therapy (CRT) is reflective of a favourable cardiac contractile response, there is limited information regarding not only its ability to predict long-term clinical outcome but also cardiac-substrate-specific differences in the prognostic value of this measure. METHODS AND RESULTS: Fifty-three heart failure patients (69 +/- 11 years) with low left ventricle ejection fraction (LVEF) (22 +/- 6%), wide QRS (169 +/- 31 ms), and indications for CRT were included. There were no significant differences in age, New York Heart Association (NYHA) class, medications, QRS width, or LVEF between ischaemic (n = 37) and non-ischaemic (n = 16) groups. Echocardiograms were performed within 24 h of implantation with device OFF and ON. Acute haemodynamic response was measured as LV dP/dt derived from the CW Doppler of mitral regurgitation. Percentage change in dP/dt was used to classify patients: high- (HR: DeltadP/dt > 25%) or poor-responders (PR: DeltadP/dt <or= 25%). Clinical response to CRT was defined by a combined endpoint of hospitalizations and all-cause mortality at 12 months. HR group had a significantly better outcome compared to the PR group (P-value = 0.004) irrespective of the aetiology of the cardiomyopathy. CONCLUSION: Echocardiographic assessment of the acute haemodynamic response to CRT predicts long-term clinical outcome in both ischaemic and non-ischaemic cardiomyopathy.
AIMS: Although acute haemodynamic improvement in response to cardiac resynchronization therapy (CRT) is reflective of a favourable cardiac contractile response, there is limited information regarding not only its ability to predict long-term clinical outcome but also cardiac-substrate-specific differences in the prognostic value of this measure. METHODS AND RESULTS: Fifty-three heart failurepatients (69 +/- 11 years) with low left ventricle ejection fraction (LVEF) (22 +/- 6%), wide QRS (169 +/- 31 ms), and indications for CRT were included. There were no significant differences in age, New York Heart Association (NYHA) class, medications, QRS width, or LVEF between ischaemic (n = 37) and non-ischaemic (n = 16) groups. Echocardiograms were performed within 24 h of implantation with device OFF and ON. Acute haemodynamic response was measured as LV dP/dt derived from the CW Doppler of mitral regurgitation. Percentage change in dP/dt was used to classify patients: high- (HR: DeltadP/dt > 25%) or poor-responders (PR: DeltadP/dt <or= 25%). Clinical response to CRT was defined by a combined endpoint of hospitalizations and all-cause mortality at 12 months. HR group had a significantly better outcome compared to the PR group (P-value = 0.004) irrespective of the aetiology of the cardiomyopathy. CONCLUSION: Echocardiographic assessment of the acute haemodynamic response to CRT predicts long-term clinical outcome in both ischaemic and non-ischaemic cardiomyopathy.
Authors: Kenneth M Stein; Kenneth A Ellenbogen; Michael R Gold; Bernd Lemke; Ignacio Fernández Lozano; Suneet Mittal; Francis G Spinale; Jennifer E Van Eyk; Alan D Waggoner; Timothy E Meyer Journal: Pacing Clin Electrophysiol Date: 2009-10-10 Impact factor: 1.976
Authors: Prabhat Kumar; Gaurav A Upadhyay; Christine Cavaliere-Ogus; E Kevin Heist; Robert K Altman; Neal A Chatterjee; Kimberly A Parks; Jagmeet P Singh Journal: J Interv Card Electrophysiol Date: 2012-12-21 Impact factor: 1.900
Authors: Marie Moonen; Mario Senechal; Bernard Cosyns; Pierre Melon; Eric Nellessen; Luc Pierard; Patrizio Lancellotti Journal: Cardiovasc Ultrasound Date: 2008-12-31 Impact factor: 2.062
Authors: Manav Sohal; Shoaib Hamid; Giovanni Perego; Paolo Della Bella; Shaumik Adhya; John Paisey; Tim Betts; Ravi Kamdar; Pier Lambiase; Francisco Leyva; Janet M McComb; Jonathan Behar; Thomas Jackson; Simon Claridge; Vishal Mehta; Mark Elliott; Steven Niederer; Reza Razavi; C Aldo Rinaldi Journal: Heart Rhythm O2 Date: 2021-01-22