Document Detail


Cardiac resynchronization therapy may improve symptoms of congestive heart failure in patients without electrical or mechanical dyssynchrony.
MedLine Citation:
PMID:  19056743     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Cardiac resynchronization therapy (CRT) has reportedly not been effective in the absence of electrical or mechanical dyssynchrony. We present six patients with severe left ventricular (LV) dilation, mitral regurgitation (MR), and non-ischaemic cardiomyopathy who underwent CRT. We assessed the effects of CRT on LV ejection fraction (EF), LV dimensions, mitral valve regurgitant fraction (RF), pulmonary arterial pressures (PAP), and serum levels of B-natriuretic peptide (BNP). METHODS AND RESULTS: All patients had severe LV dilation (>/=6.8 cm) and no electrical or mechanical dyssynchrony. All patients underwent CRT-D (with defibrillator) without complications. Average echocardiographic follow-up was 4.6 months. Mean LVEF increased significantly from 20.8 +/- 3.4 to 28.3 +/- 2.9% after CRT (P < 0.01). Mean LV end-diastolic dimension decreased significantly from 6.9 +/- 0.15 to 6.45 +/- 0.33 cm after CRT (P = 0.03); mean BNP serum level decreased from 1738 +/- 526 to 1040 +/- 768 pg/mL (P = 0.07). Baseline RF decreased from 45 +/- 12.2 to 20 +/- 10.9% after CRT-D (P = 0.009). Mean PAP decreased from 48.5 +/- 5.8 to 42.6 +/- 5.2 (P = 0.03). In five patients, New York Heart Association class symptoms improved by at least one level. No patients required assist devices or transplantation. One patient was hospitalized during follow-up. CONCLUSION: We describe six patients with severe LV dilation without evidence of electrical or mechanical dyssynchrony who improved with CRT, possibly due to improvement in MR.
Authors:
Alireza Nazeri; Ali Massumi; Abdi Rasekh; Mohammad Saeed; Christopher Frank; J Michael Wilson; J Alberto Lopez; Mehdi Razavi
Related Documents :
22424003 - A randomized controlled trial of oxygen therapy in acute myocardial infarction air vers...
22294543 - Deferring coronary stenting for myocardial bridging by fractional flow reserve and opti...
8752803 - Which patient benefits from early angiotensin-converting enzyme inhibition after myocar...
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-12-04
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  11     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-17     Completed Date:  2009-03-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  86-8     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Texas Heart Institute at St Luke's Episcopal Hospital, Houston, 6624 Fannin, Suite 2480, Houston, TX, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Cardiac Pacing, Artificial / methods*
Female
Heart Failure / complications,  diagnosis*,  prevention & control*
Humans
Male
Middle Aged
Treatment Outcome
Ventricular Dysfunction, Left / complications,  diagnosis*,  prevention & control*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Insulin receptor substrate-2 regulates aerobic glycolysis in mouse mammary tumor cells via glucose t...
Next Document:  Long-term results of high vs. normal impedance ventricular leads on actual (Real-Life) pacemaker gen...