Acute Modifications of Left Ventricular Torsional Mechanics Induced by Cardiac Resynchronization Therapy Affect Short-Term Reverse Remodeling
| Autor: | Paolo Marino, Paolo Devecchi, Anna Degiovanni, Chiara Sartori, Federica Devecchi |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
genetic structures Systole medicine.medical_treatment Population Cardiac resynchronization therapy Echocardiography Three-Dimensional Speckle tracking echocardiography 030204 cardiovascular system & hematology Right atrial Ventricular Function Left Cardiac Resynchronization Therapy 03 medical and health sciences Ventricular Dysfunction Left 0302 clinical medicine medicine Humans cardiovascular diseases 030212 general & internal medicine education Reverse remodeling End-systolic volume Aged Aged 80 and over Heart Failure education.field_of_study Ventricular Remodeling business.industry Torsion (mechanics) Stroke Volume General Medicine Mechanics Middle Aged equipment and supplies medicine.disease Treatment Outcome Heart failure cardiovascular system Female Cardiology and Cardiovascular Medicine business circulatory and respiratory physiology |
| Zdroj: | Circulation journal : official journal of the Japanese Circulation Society. 83(2) |
| ISSN: | 1347-4820 |
| Popis: | BACKGROUND Left ventricular (LV) torsion is an important aspect of cardiac mechanics and is altered in heart failure patients. Cardiac resynchronization therapy (CRT) has a positive effect on LV function, but the exact mechanisms through which it works are not completely depicted. Our aim was to investigate (1) the acute CRT effect on LV torsional mechanics in heart failure patients using 3D speckle tracking echocardiography (3DSTE) and (2) its effect on short-term LV remodeling. Methods and Results: We considered 48 patients (age 72±11 years, 35 men) who received CRT. They underwent 3DSTE during CRT-on (biventricular stimulation) vs. CRT-off (intrinsic conduction/right atrial/ventricular stimulation alone), in a random fashion. Patients were classified as CRT responders based on LV systolic volume reduction ≥15% at 6 months (final population: 31 responders, 17 non-responders). Acute CRT positively affected responders in terms of LV torsion (from 0.32±0.06°/cm CRT-off to 0.41±0.06°/cm CRT-on), but adversely affected non-responders (from 0.54±0.08°/cm CRT-off to 0.28±0.08°/cm CRT-on, interaction P=0.02). A similar trend was confirmed for apical (interaction P |
| Databáze: | OpenAIRE |
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