Impact of cardiac resynchronization therapy using hemodynamically optimized pacing on left ventricular remodeling in patients with congestive heart failure and ventricular conduction disturbances.

摘要: OBJECTIVES We sought to investigate the impact of six months cardiac resynchronization therapy (CRT) on echocardiographic variables left ventricular (LV) function. BACKGROUND Cardiac has recently been introduced as a new therapeutic modality in patients with advanced heart failure (HF) and conduction abnormalities. However, most studies have only investigated early hemodynamic effects CRT. METHODS Twenty-five (12 women 13 men; 59.8 5.1 years old) HF caused by ischemic (n 7) or idiopathic dilated cardiomyopathy 18) prolonged QRS complex were analyzed. All underwent testing randomized protocol; measurements compared before implantation after RESULTS Left end-diastolic end-systolic diameters (LVEDD LVESD, respectively) significantly reduced from 71 10 68 11 mm, p 0.027; LVESD 63 58 0.007), LV volumes (LVEDV 253 83 227 112 ml, 0.017; LVESV 202 79 174 101 0.009). Ejection fraction was increased (from 22 7% 26 9%, 0.03). “Nonresponders,” regard volume reduction, had higher baseline LVEDV, “responders” (351 52 vs. 234 74 0.018). Overall, there mild mitral regurgitation at baseline, minor reduction semiquantitative analysis. The results did not predict response. CONCLUSIONS may lead disturbances. Volume nonresponders LVEDV. (J Am Coll Cardiol 2001;38:1957– 65) © 2001 American College Cardiology