Document Detail

Exercise stress echocardiography is superior to rest echocardiography in predicting left ventricular reverse remodelling and functional improvement after cardiac resynchronization therapy.
MedLine Citation:
PMID:  18987095     Owner:  NLM     Status:  MEDLINE    
AIMS: Cardiac resynchronization therapy (CRT) improves functional capacity and survival in heart failure. However, one-third of patients fail to respond to CRT. Resting left ventricular (LV) dyssynchrony assessed by echocardiography (ECHO) showed discordant results in identifying CRT responders. LV dyssynchrony can totally change during exercise. Aim of this study was to evaluate whether exercise dyssynchrony could select responders to CRT. METHODS AND RESULTS: Sixty-four patients scheduled for CRT implantation performed bicycle exercise ECHO in semi-supine position on an exercise tilting table before and 6 months after CRT implantation. Tissue Doppler imaging (TDI) was acquired both at rest and during exercise to detect LV mechanical dyssynchrony. Predictive values for CRT response were 70% for rest TDI and 89% for exercise TDI (P = 0.01). Exercise LV dyssynchrony was the only parameter independently associated with follow-up improvement of rest ejection fraction and LV volume during multivariable analysis (P < 0.001). Functional improvement at 6-min walking test was statistically higher in patients with exercise dyssynchrony (P = 0.005), and not different considering rest dyssynchrony (P = 0.30). CONCLUSION: Exercise intraventricular dyssynchrony assessed by exercise TDI ECHO is a strong independent predictor of CRT response. It could be used to select candidates for CRT, thus reducing ineffective implantations of biventricular pacemakers.
Guido Rocchi; Matteo Bertini; Mauro Biffi; Matteo Ziacchi; Elena Biagini; Ilaria Gallelli; Cristian Martignani; Elena Cervi; Marinella Ferlito; Claudio Rapezzi; Angelo Branzi; Giuseppe Boriani
Related Documents :
22574715 - Effects of an in-patient treatment program based on regular exercise and a balanced die...
22823075 - Effects of 2 different prior endurance exercises on whole-body fat oxidation kinetics: ...
6645045 - Left ventricular size and performance during graded supine exercise in normal subjects.
3621535 - Aortic valve replacement with a small prosthesis.
25202185 - Selective activation of lumbar paraspinal muscles during various exercises in the prone...
11887545 - Microbial growth on the anesthesia machine.
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-11-05
Journal Detail:
Title:  European heart journal     Volume:  30     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-02     Completed Date:  2009-01-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  89-97     Citation Subset:  IM    
Institute of Cardiology, University of Bologna, Azienda Ospedaliera S. Orsola-Malpighi, Bologna, Italy.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Cardiac Pacing, Artificial
Cardiomyopathy, Dilated / diagnosis*,  physiopathology,  therapy
Echocardiography, Doppler, Pulsed
Echocardiography, Stress*
Exercise Test*
Follow-Up Studies
Logistic Models
Middle Aged
Patient Selection*
Prospective Studies
Sensitivity and Specificity
Ventricular Remodeling*

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

Previous Document:  Project IMPACT: brief report on a pilot programme promoting physical activity among university stude...
Next Document:  Angiographic and clinical outcome of invasively managed patients with thrombosed coronary bare metal...