Abstract
Background: Cardiac resynchronization therapy (CRT) is an emerging treatment for heart failure patients with left bundle branch block; in these patients left ventricle filling pattern (LVFP) abnormalities are recognized as cause of symptoms and predictors of outcome. We investigated the effects of CRT on diastolic function and the prognostic value of LVFP in patients on CRT. Methods: 65 patients treated with CRT were studied over a 12 months period. At baseline, according to defined echocardiographic criteria, restrictive LVFP (RFP) was present in 25 patients, whereas 40 patients showed no-RFP. Results: After CRT, opposite changes occurred in the two groups. In no-RFP patients, early-to-atrial filling velocity ratio (E / A) increased from 0.8 ± 0.3 to 1.0 ± 0.6 (p = 0.006) and E wave deceleration time (DT) decreased from 234 ± 83 ms to 196 ± 51 ms (p = 0.028). In 13 RFP patients, E / A decreased from 2.2 ± 0.9 to 0.8 ± 0.5 and DT increased from 128 ± 43 ms to 205 ± 52 ms (both p <0.001), leading to reversal of RFP. In both groups, clinical, functional and echographic benefits were evident, with mortality rates of 5% (2 / 40) and 15% (2 / 13) respectively. The remaining patients showed persistence of RFP (E / A and DT unchanged), no improvement and a mortality rate of 42% (5 / 12) (p = 0.005, versus no-RFP). Conclusions: CRT improves diastolic function, inducing also reversal of LVFP in a consistent number of RFP patients. The persistence of RFP after CRT is associated to an extremely poor prognosis.
| Original language | English |
|---|---|
| Pages (from-to) | 322-328 |
| Number of pages | 7 |
| Journal | International Journal of Cardiology |
| Volume | 112 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Oct 10 2006 |
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Keywords
- Diastole
- Heart failure
- Pacing
- Prognosis
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Evolution and prognostic significance of diastolic filling pattern in cardiac resynchronization therapy. / Porciani, Maria Cristina; Valsecchi, Sergio; Demarchi, Gabriele; Colella, Andrea; Michelucci, Antonio; Pieragnoli, Paolo; Musilli, Nicola; Gensini, Gian Franco; Padeletti, Luigi.
In: International Journal of Cardiology, Vol. 112, No. 3, 10.10.2006, p. 322-328.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Evolution and prognostic significance of diastolic filling pattern in cardiac resynchronization therapy
AU - Porciani, Maria Cristina
AU - Valsecchi, Sergio
AU - Demarchi, Gabriele
AU - Colella, Andrea
AU - Michelucci, Antonio
AU - Pieragnoli, Paolo
AU - Musilli, Nicola
AU - Gensini, Gian Franco
AU - Padeletti, Luigi
PY - 2006/10/10
Y1 - 2006/10/10
N2 - Background: Cardiac resynchronization therapy (CRT) is an emerging treatment for heart failure patients with left bundle branch block; in these patients left ventricle filling pattern (LVFP) abnormalities are recognized as cause of symptoms and predictors of outcome. We investigated the effects of CRT on diastolic function and the prognostic value of LVFP in patients on CRT. Methods: 65 patients treated with CRT were studied over a 12 months period. At baseline, according to defined echocardiographic criteria, restrictive LVFP (RFP) was present in 25 patients, whereas 40 patients showed no-RFP. Results: After CRT, opposite changes occurred in the two groups. In no-RFP patients, early-to-atrial filling velocity ratio (E / A) increased from 0.8 ± 0.3 to 1.0 ± 0.6 (p = 0.006) and E wave deceleration time (DT) decreased from 234 ± 83 ms to 196 ± 51 ms (p = 0.028). In 13 RFP patients, E / A decreased from 2.2 ± 0.9 to 0.8 ± 0.5 and DT increased from 128 ± 43 ms to 205 ± 52 ms (both p <0.001), leading to reversal of RFP. In both groups, clinical, functional and echographic benefits were evident, with mortality rates of 5% (2 / 40) and 15% (2 / 13) respectively. The remaining patients showed persistence of RFP (E / A and DT unchanged), no improvement and a mortality rate of 42% (5 / 12) (p = 0.005, versus no-RFP). Conclusions: CRT improves diastolic function, inducing also reversal of LVFP in a consistent number of RFP patients. The persistence of RFP after CRT is associated to an extremely poor prognosis.
AB - Background: Cardiac resynchronization therapy (CRT) is an emerging treatment for heart failure patients with left bundle branch block; in these patients left ventricle filling pattern (LVFP) abnormalities are recognized as cause of symptoms and predictors of outcome. We investigated the effects of CRT on diastolic function and the prognostic value of LVFP in patients on CRT. Methods: 65 patients treated with CRT were studied over a 12 months period. At baseline, according to defined echocardiographic criteria, restrictive LVFP (RFP) was present in 25 patients, whereas 40 patients showed no-RFP. Results: After CRT, opposite changes occurred in the two groups. In no-RFP patients, early-to-atrial filling velocity ratio (E / A) increased from 0.8 ± 0.3 to 1.0 ± 0.6 (p = 0.006) and E wave deceleration time (DT) decreased from 234 ± 83 ms to 196 ± 51 ms (p = 0.028). In 13 RFP patients, E / A decreased from 2.2 ± 0.9 to 0.8 ± 0.5 and DT increased from 128 ± 43 ms to 205 ± 52 ms (both p <0.001), leading to reversal of RFP. In both groups, clinical, functional and echographic benefits were evident, with mortality rates of 5% (2 / 40) and 15% (2 / 13) respectively. The remaining patients showed persistence of RFP (E / A and DT unchanged), no improvement and a mortality rate of 42% (5 / 12) (p = 0.005, versus no-RFP). Conclusions: CRT improves diastolic function, inducing also reversal of LVFP in a consistent number of RFP patients. The persistence of RFP after CRT is associated to an extremely poor prognosis.
KW - Diastole
KW - Heart failure
KW - Pacing
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=33748789843&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33748789843&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2005.10.002
DO - 10.1016/j.ijcard.2005.10.002
M3 - Article
C2 - 16318886
AN - SCOPUS:33748789843
VL - 112
SP - 322
EP - 328
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 3
ER -