Abstract
OBJECTIVE: Cardiac resynchronisation therapy has proven to be effective in refractory heart failure (HF) patients with QRS >120-130 ms. Therefore, the aim of our study was to verify the long-term effectiveness of cardiac resynchronisation therapy in HF patients with echocardiographic evidence of mechanical asynchrony regardless of QRS duration. METHODS: One hundred and six patients with New York Heart Association class II-IV HF and echocardiographic documentation of interventricular and intraventricular asynchrony underwent biventricular stimulation. A clinical and functional evaluation was performed at baseline, 1, 3, 6 months, and every 6 months thereafter. RESULTS: After a median follow-up of 16 months, a significant improvement was noted in ejection fraction, left ventricular diameters, mitral regurgitation jet area, interventricular and intraventricular echocardiographic indexes of asynchrony, and the 6-min walking distance (P <0.001 for all). Death rates for all causes and for cardiac causes were 18.2 (95% confidence interval 12.8-25.9) and 13.5 (95% confidence interval 9.0-20.3) per 100 person-years, respectively. Patients in New York Heart Association class IV had an almost three-fold increase in risk of dying as compared to class II-III (hazard ratio 2.97, 95% confidence interval 1.30-6.79). CONCLUSIONS: Interventricular and intraventricular asynchrony at echocardiography may be useful in identifying HF patients suitable for cardiac resynchronisation therapy, with results comparable to those obtained with QRS duration selection criteria.
| Original language | English |
|---|---|
| Pages (from-to) | 131-136 |
| Number of pages | 6 |
| Journal | Journal of Cardiovascular Medicine |
| Volume | 9 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Feb 2008 |
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Keywords
- Cardiac resynchronisation therapy
- Heart failure
- Mechanical asynchrony
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Effectiveness of cardiac resynchronisation therapy in patients with echocardiographic evidence of mechanical dyssynchrony. / Achilli, Augusto; Sassara, Massimo; Pontillo, Daniele; Turreni, Federico; Rossi, Pietro; De Luca, Rosanna; Klersy, Catherine; Patruno, Nicolino; Achilli, Paola; Sallusti, Luciano; Spadaccia, Paolo; Cricco, Luigi; Serra, Francesco.
In: Journal of Cardiovascular Medicine, Vol. 9, No. 2, 02.2008, p. 131-136.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effectiveness of cardiac resynchronisation therapy in patients with echocardiographic evidence of mechanical dyssynchrony
AU - Achilli, Augusto
AU - Sassara, Massimo
AU - Pontillo, Daniele
AU - Turreni, Federico
AU - Rossi, Pietro
AU - De Luca, Rosanna
AU - Klersy, Catherine
AU - Patruno, Nicolino
AU - Achilli, Paola
AU - Sallusti, Luciano
AU - Spadaccia, Paolo
AU - Cricco, Luigi
AU - Serra, Francesco
PY - 2008/2
Y1 - 2008/2
N2 - OBJECTIVE: Cardiac resynchronisation therapy has proven to be effective in refractory heart failure (HF) patients with QRS >120-130 ms. Therefore, the aim of our study was to verify the long-term effectiveness of cardiac resynchronisation therapy in HF patients with echocardiographic evidence of mechanical asynchrony regardless of QRS duration. METHODS: One hundred and six patients with New York Heart Association class II-IV HF and echocardiographic documentation of interventricular and intraventricular asynchrony underwent biventricular stimulation. A clinical and functional evaluation was performed at baseline, 1, 3, 6 months, and every 6 months thereafter. RESULTS: After a median follow-up of 16 months, a significant improvement was noted in ejection fraction, left ventricular diameters, mitral regurgitation jet area, interventricular and intraventricular echocardiographic indexes of asynchrony, and the 6-min walking distance (P <0.001 for all). Death rates for all causes and for cardiac causes were 18.2 (95% confidence interval 12.8-25.9) and 13.5 (95% confidence interval 9.0-20.3) per 100 person-years, respectively. Patients in New York Heart Association class IV had an almost three-fold increase in risk of dying as compared to class II-III (hazard ratio 2.97, 95% confidence interval 1.30-6.79). CONCLUSIONS: Interventricular and intraventricular asynchrony at echocardiography may be useful in identifying HF patients suitable for cardiac resynchronisation therapy, with results comparable to those obtained with QRS duration selection criteria.
AB - OBJECTIVE: Cardiac resynchronisation therapy has proven to be effective in refractory heart failure (HF) patients with QRS >120-130 ms. Therefore, the aim of our study was to verify the long-term effectiveness of cardiac resynchronisation therapy in HF patients with echocardiographic evidence of mechanical asynchrony regardless of QRS duration. METHODS: One hundred and six patients with New York Heart Association class II-IV HF and echocardiographic documentation of interventricular and intraventricular asynchrony underwent biventricular stimulation. A clinical and functional evaluation was performed at baseline, 1, 3, 6 months, and every 6 months thereafter. RESULTS: After a median follow-up of 16 months, a significant improvement was noted in ejection fraction, left ventricular diameters, mitral regurgitation jet area, interventricular and intraventricular echocardiographic indexes of asynchrony, and the 6-min walking distance (P <0.001 for all). Death rates for all causes and for cardiac causes were 18.2 (95% confidence interval 12.8-25.9) and 13.5 (95% confidence interval 9.0-20.3) per 100 person-years, respectively. Patients in New York Heart Association class IV had an almost three-fold increase in risk of dying as compared to class II-III (hazard ratio 2.97, 95% confidence interval 1.30-6.79). CONCLUSIONS: Interventricular and intraventricular asynchrony at echocardiography may be useful in identifying HF patients suitable for cardiac resynchronisation therapy, with results comparable to those obtained with QRS duration selection criteria.
KW - Cardiac resynchronisation therapy
KW - Heart failure
KW - Mechanical asynchrony
UR - http://www.scopus.com/inward/record.url?scp=38149088246&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=38149088246&partnerID=8YFLogxK
U2 - 10.2459/JCM.0b013e328010396d
DO - 10.2459/JCM.0b013e328010396d
M3 - Article
C2 - 18192804
AN - SCOPUS:38149088246
VL - 9
SP - 131
EP - 136
JO - Journal of Cardiovascular Medicine
JF - Journal of Cardiovascular Medicine
SN - 1558-2027
IS - 2
ER -