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Titolo:
Impact of cardiac resynchronization therapy using hemodynamically optimized pacing on left ventricular remodeling in patients with congestive heart failure and ventricular conduction disturbances
Autore:
Stellbrink, C; Breithardt, OA; Franke, A; Sack, S; Bakker, P; Auricchio, A; Pochet, T; Salo, R; Kramer, A; Spinelli, J;
Indirizzi:
Rhein Westfal TH Aachen, Med Klin 1, Dept Cardiol, D-52057 Aachen, GermanyRhein Westfal TH Aachen Aachen Germany D-52057 , D-52057 Aachen, Germany Univ Hosp Essen, Dept Cardiol, Essen, Germany Univ Hosp Essen Essen Germany Hosp Essen, Dept Cardiol, Essen, Germany Univ Utrecht Hosp, Heart Lung Inst, Utrecht, Netherlands Univ Utrecht Hosp Utrecht Netherlands t Lung Inst, Utrecht, Netherlands Univ Hosp, Dept Cardiol, Magdeburg, Germany Univ Hosp Magdeburg GermanyUniv Hosp, Dept Cardiol, Magdeburg, Germany Guidant Corp, Brussels, Belgium Guidant Corp Brussels BelgiumGuidant Corp, Brussels, Belgium Guidant Corp, St Paul, MN USA Guidant Corp St Paul MN USAGuidant Corp, St Paul, MN USA
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 7, volume: 38, anno: 2001,
pagine: 1957 - 1965
SICI:
0735-1097(200112)38:7<1957:IOCRTU>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
IDIOPATHIC DILATED CARDIOMYOPATHY; ECHOCARDIOGRAPHIC MEASUREMENTS; MITRAL REGURGITATION; SHAPE; CARVEDILOL; MECHANICS; SURVIVAL; DISEASE; DELAY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Stellbrink, C Rhein Westfal TH Aachen, Med Klin 1, Dept Cardiol, Paulwelsstr 30, D-52057Aachen, Germany Rhein Westfal TH Aachen Paulwelsstr 30 Aachen Germany D-52057
Citazione:
C. Stellbrink et al., "Impact of cardiac resynchronization therapy using hemodynamically optimized pacing on left ventricular remodeling in patients with congestive heart failure and ventricular conduction disturbances", J AM COL C, 38(7), 2001, pp. 1957-1965

Abstract

OBJECTIVES We sought to investigate the impact of six months of cardiac resynchronization therapy (CRT) on echocardiographic variables of left ventricular (LV) function. BACKGROUND Cardiac resynchronization therapy has recently been introduced as a new therapeutic modality in patients with advanced heart failure (HF) and conduction abnormalities. However, most studies have only investigated the early hemodynamic effects of CRT. METHODS Twenty-five patients (12 women and 13 men; 59.8 +/- 5.1 years old)with advanced HF caused by ischemic (n = 7) or idiopathic dilated cardiomyopathy (n = 18) and a prolonged QRS complex were analyzed. All patients underwent early hemodynamic testing with a randomized testing protocol; echo cardiographic measurements were compared before implantation and after six months of CRT. RESULTS Left ventricular end-diastolic and end-systolic diameters (LVEDD and LVESD, respectively) were significantly reduced after six months (LVEDD from 71 +/- 10 to 68 +/- 11 mm, p = 0.027; LVESD from 63 +/- 11 to 58 +/- 11 mm, p = 0.007), as were LV end-diastolic and end-systolic volumes (LVEDV from 253 +/- 83 to 227 +/- 112 ml, p = 0.017; LVESV from 202 +/- 79 to 174 /- 101 ml, p = 0.009). Ejection fraction was significantly increased (from22 +/- 7% to 26 +/- 9%, p = 0.03). "Nonresponders," with regard to LV volume reduction, had significantly higher baseline LVEDV, compared with "responders" (351 +/- 52 vs. 234 +/- 74 ml, p = 0.018). Overall, there was only mild mitral regurgitation at baseline, with a minor reduction by semiquantitative analysis. The results of early hemodynamic testing did not predict the volume response. CONCLUSIONS Cardiac resynchronization therapy may lead to a reduction in LV volumes in patients with advanced HF and conduction disturbances. Volume nonresponders have significantly higher baseline LVEDV. (J Am Coll Cardiol 2001;39:1957-65) (C) 2001 by the American College of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/12/20 alle ore 12:03:13