Document Detail

Mechanical dyssynchrony by 3D echo correlates with acute haemodynamic response to biventricular pacing in heart failure patients.
MedLine Citation:
PMID:  18065485     Owner:  NLM     Status:  MEDLINE    
AIMS: One-third of dilated cardiomyopathy patients receiving a biventricular pacing-device do not respond to this form of therapy. Therefore, the utility of mechanical dyssynchrony by real-time 3D echocardiography (RT3DE) for predicting systolic response to biventricular pacing, of which maximal rate of pressure rise (dP/dt(max)) served as the gold-standard, was evaluated. METHODS AND RESULTS: Seventeen consecutive heart failure patients (aged 64 +/- 10 years, 8 male, 6 ischaemic cardiomyopathy, mean QRS duration 136 +/- 32 ms) underwent RT3DE and biventricular pacing. Post-processing software provided data of global left ventricular (LV) function and the systolic dyssynchrony index of 17 LV segments (SDI(17), %) for mechanical dyssynchrony. During biventricular pacing, percentual change in dP/dt(max) compared to the non-pacing mode, DeltadP/dt(max) was measured invasively with conductance catheters. LV ejection fraction was 31 +/- 10%, SDI(17) was 10.2 +/- 4.2% and percentual DeltadP/dt(max) during biventricular pacing was 14.5 +/- 12.4. A significant correlation (r = 0.729, P = 0.001) was found between SDI(17) and percentual DeltadP/dt(max), and between QRS duration and percentual DeltadP/dt(max) (r = 0.721, P = 0.001). CONCLUSION: The present study suggests that mechanical dyssynchrony measured by RT3DE shows a good correlation with invasively determined acute haemodynamic response to biventricular pacing in patients with symptomatic dilated cardiomyopathy. Future studies are needed to further define the clinical utility of RT3DE in identifying patients who are most likely to respond to cardiac resynchronization therapy.
J van Dijk; P Knaapen; I K Russel; T Hendriks; C P Allaart; C C de Cock; O Kamp
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-12-07
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:  10     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-17     Completed Date:  2008-03-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  63-8     Citation Subset:  IM    
Department of Cardiology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
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MeSH Terms
Cardiac Pacing, Artificial / methods*
Echocardiography, Three-Dimensional
Heart Failure / physiopathology,  therapy*,  ultrasonography*
Heart Ventricles / physiopathology*,  ultrasonography*
Middle Aged
Pacemaker, Artificial
Patient Selection
Pilot Projects
Predictive Value of Tests
Stroke Volume / physiology
Systole / physiology*
Treatment Outcome
Ventricular Dysfunction, Left / physiopathology,  ultrasonography

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

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