Cardiac electrical and mechanical synchrony of super-responders to cardiac resynchronization therapy.

Autor:	Li KB; Department of Cardiology, The Affiliated Zhangjiagang Hospital of Soochow University, Zhangjiagang, Jiangsu 215600, China., Qian ZY; Department of Cardiology, First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China., Qian XS; Department of Cardiology, The Affiliated Zhangjiagang Hospital of Soochow University, Zhangjiagang, Jiangsu 215600, China., Zhou Y; Department of Cardiology, The Affiliated Zhangjiagang Hospital of Soochow University, Zhangjiagang, Jiangsu 215600, China., Zhu DD; Department of Cardiology, First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China.; Department of Cardiology, Zhongda Hospital Southeast University, Nanjing, Jiangsu 210029, China., Qiu YH; Department of Cardiology, First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China., Wang Y; Department of Cardiology, First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China., Hou XF; Department of Cardiology, First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China., Zou JG; Department of Cardiology, First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China., Sheng YF; Department of Cardiology, The Affiliated Zhangjiagang Hospital of Soochow University, Zhangjiagang, Jiangsu 215600, China.
Jazyk:	angličtina
Zdroj:	Chinese medical journal [Chin Med J (Engl)] 2020 Jan 20; Vol. 133 (2), pp. 141-147.
DOI:	10.1097/CM9.0000000000000600
Abstrakt:	Background: Super-responders (SRs) to cardiac resynchronization therapy (CRT) regain near-normal or normal cardiac function. The extent of cardiac synchrony of SRs and whether continuous biventricular (BIV) pacing is needed remain unknown. The aim of this study was to evaluate the cardiac electrical and mechanical synchrony of SRs. Methods: We retrospectively analyzed CRT recipients between 2008 and 2016 in 2 centers to identify SRs, whose left ventricular (LV) ejection fraction was increased to ≥50% at follow-up. Cardiac synchrony was evaluated in intrinsic and BIV-paced rhythms. Electrical synchrony was estimated by QRS duration and LV mechanical synchrony by single-photon emission computed tomography myocardial perfusion imaging. Results: Seventeen SRs were included with LV ejection fraction increased from 33.0 ± 4.6% to 59.3 ± 6.3%. The intrinsic QRS duration after super-response was 148.8 ± 30.0 ms, significantly shorter than baseline (174.8 ± 11.9 ms, P = 0.004, t = -3.379) but longer than BIV-paced level (135.5 ± 16.7 ms, P = 0.042, t = 2.211). Intrinsic LV mechanical synchrony significantly improved after super-response (phase standard deviation [PSD], 51.1 ± 16.5° vs. 19.8 ± 8.1°, P < 0.001, t = 5.726; phase histogram bandwidth (PHB), 171.7 ± 64.2° vs. 60.5 ± 22.9°, P < 0.001, t = 5.376) but was inferior to BIV-paced synchrony (PSD, 19.8 ± 8.1° vs. 15.2 ± 6.4°, P = 0.005, t = 3.414; PHB, 60.5 ± 22.9° vs. 46.0 ± 16.3°, P = 0.009, t = 3.136). Conclusions: SRs had significant improvements in cardiac electrical and LV mechanical synchrony. Since intrinsic synchrony of SRs was still inferior to BIV-paced rhythm, continued BIV pacing is needed to maintain longstanding and synchronized contraction.
Databáze:	MEDLINE
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