Time delay to peak left ventricular pressure rise identifies the substrate for dyssynchronous heart failure and detects disease modification with resynchronization- an observational clinical study
| Autor: | LO Gammelsrud, Erik Kongsgård, Torbjørn Holm, H H Odland, Richard Cornelussen, Stian Ross |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Ventricular End-Systolic Volume business.industry Left bundle branch block medicine.medical_treatment Cardiac resynchronization therapy Diastole medicine.disease Disease modification Physiology (medical) Heart failure Internal medicine Ventricular pressure Cardiology Medicine Observational study Cardiology and Cardiovascular Medicine business |
| Zdroj: | EP Europace. 23 |
| ISSN: | 1532-2092 1099-5129 |
| DOI: | 10.1093/europace/euab116.456 |
| Popis: | Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Norwegian South East Health Authorities Introduction Identification of disease modification prior to implantation of Cardiac Resynchronization Therapy may help select the right patients, increase responder-rates and promote the utilization of CRT. We tested the hypothesis that shortening of time-to-peak left ventricular pressure rise (Td) with CRT is useful to predict long-term volumetric response (End-systolic volume (ESV) decrease >15%) to CRT. Methods Forty-five heart failure patients admitted for CRT implantation with a class I/IIa indication according to current ESC/AHA guidelines were included in the study. Td was measured from onset QRS at baseline and from onset of pacing with CRT. Results Baseline characteristics were mean age 63 ± 10 years , 71% males, NYHA class 2.5, 87% LBBB, QRS duration 173 ± 15ms, EF biplane 31 ± 1%, ESV 144 ± 12mL and end-diastolic volume 2044 ± 14mL. At 6-months follow-up six patients increased ESV by 5 ± 8%, while 37 responders (85%) had a mean ESV decrease of 40 ± 2%. Responders presented with a higher Td at baseline compared to non-responders (163 ± 4ms vs 119 ± 9ms, p Conclusions Td at baseline and the shortening of Td with CRT accurately identifies responders to CRT, with incremental value on top of current guidelines, in a population with already high response rates. Td carries the potential to become the marker for prediction of long-term volumetric response in CRT candidates. Abstract Figure. |
| Databáze: | OpenAIRE |
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