| Effect of biventricular pacing on diastolic dyssynchrony. | |
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MedLine Citation:
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PMID: 21029873 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: This study sought to examine the changes in diastolic dyssynchrony with cardiac resynchronization therapy (CRT). BACKGROUND: Little is known about the effect of CRT on diastolic dyssynchrony. METHODS: Consecutive heart failure patients (n = 266, age 65.7 ± 10.0 years) underwent color-coded tissue Doppler imaging at baseline, 48 h, and 6 months after CRT. Systolic and diastolic dyssynchrony were defined as maximal time delay in peak systolic and early diastolic velocities, respectively, in 4 basal LV segments. CRT responders were defined as those with ≥15% decrease in LV end-systolic volume at 6 months. RESULTS: Baseline LVEF was 25.2 ± 8.1%; 63.5% patients were CRT responders. Baseline incidence of systolic and diastolic dyssynchrony, and a combination of both was 46.2%, 51.9%, and 28.6%, respectively. Compared to nonresponders, responders had longer baseline systolic (79.2 ± 43.4 ms vs. 45.4 ± 30.4 ms; p < 0.001) and diastolic (78.5 ± 52.0 ms vs. 50.1 ± 38.2 ms; p < 0.001) delays. In follow-up, systolic delays (45.4 ± 31.6 ms at 48 h; 38.9 ± 26.2 ms at 6 months; p < 0.001) and diastolic delays (49.4 ± 36.3 ms at 48 h; 37.7 ± 26.0 ms at 6 months; p < 0.001) improved only in responders. CONCLUSIONS: At baseline: 1) diastolic dyssynchrony was more common than systolic dyssynchrony in HF patients; 2) nonresponders had less baseline diastolic dyssynchrony compared to responders. After CRT: 1) diastolic dyssynchrony improved only in responders. Further insight into the pathophysiology of diastolic dyssynchrony and its changes with CRT may provide incremental information on patient-specific treatments. |
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Authors:
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Miriam Shanks; Matteo Bertini; Victoria Delgado; Arnold C T Ng; Gaetano Nucifora; Rutger J van Bommel; C Jan Willem Borleffs; Eduard R Holman; Nico R L van de Veire; Martin J Schalij; Jeroen J Bax |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 56 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-29 Completed Date: 2010-11-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1567-75 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiac Pacing, Artificial* / methods Diastole / physiology Female Follow-Up Studies Heart Failure, Diastolic / physiopathology*, therapy* Humans Male Middle Aged Treatment Outcome Ventricular Dysfunction, Left / physiopathology*, therapy* |
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