Reverse Ventricular remodeling and improved functional capacity after ventricular resynchronzation in advanced heart failure

Gabriella Malfatto, Mario Facchini, Giovanna Branzi, Roberto Brambilla, Gerardina Fratianni, Elena Tortorici, Eva Balla, Giovanni B. Perego

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Ventricular resynchronization is a non-pharmacological treatment for advanced heart failure refractory to drug therapy and with intraventricular conduction delay. We describe the time course of echocardiographic and functional recovery after resynchronization in 31 patients (mean age 67 ± 8 years). Methods. We evaluated NYHA class, echocardiogram, respiratory function, and cardiopulmonary test before pacemaker implantation (baseline), after 1-3 months (short-term evaluation), and 10-15 months afterwards long-term evaluation, n = 21 patients). Mortality at 1 year was considered. Results. Both at short and long term, patients improved NYHA class, ventricular function, and ventricular volumes. Already at short term, we observed an increase in oxygen consumption at peak exercise (12.6 ± 0.6 vs 10.5 ± 0.5 ml/kg/min), oxygen consumption at anaerobic threshold (9.8 ± 0.6 vs 8.3 ± 0.6 ml/kg/min) and oxygen pulse (8.3 ± 0.5 vs 7.5 ± 0.5 ml/beat). Ventilatory efficacy (VE/VCO2 slope) and alveolo-capillary diffusion (estimated by the measurement of lung diffusion capacity for carbon monoxide - DLCO) improved only at long term (VE/VCO2: 40.7 ± 1.6 vs 45.3 ± 1.8; DLCO: 70.3 ± 2.7 vs 59.4 ± 5.9% of predicted, p = 0.05). The 1-year mortality was 9.7%. Conclusions. Ventricular resynchronization is linked to a fast and prolonged recovery of NYHA class, echocardiographic variables and stress tolerance. The improvement of indexes known to carry a prognostic value confirms that ventricular resynchronization can positively interfere with the evolution of the disease.

Original languageEnglish
Pages (from-to)578-583
Number of pages6
JournalItalian Heart Journal
Volume6
Issue number7
Publication statusPublished - Jul 2005

Keywords

  • Cardiac resynchronization therapy
  • Cardiopulmonary stress test
  • Echocardiography
  • Heart failure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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