Effects of long-term biventricular stimulation for resynchronization on echocardiographic measures of remodeling.
BACKGROUND
Long-term ventricular resynchronization therapy improves symptom status. Changes in left ventricular remodeling have not been adequately evaluated.


RESULTS
Fifty-three patients with systolic heart failure and bundle-branch block underwent implantation of biventricular stimulation (BVS) devices as part of a randomized trial. Echocardiograms were acquired at randomization and at 6-week intervals until completion of 12 weeks of continuous BVS. There were no changes in heart rate or QRS duration after 12 weeks of BVS. Serum norepinephrine values did not change with BVS. After 12 weeks of BVS, left atrial volume decreased. Left ventricular end-systolic and end-diastolic dimensions and left ventricular end-systolic volume also decreased after 12 weeks of BVS. Sphericity index did not change. Measures of systolic function, including left ventricular outflow tract and aortic velocity time integral and myocardial performance index, improved.


CONCLUSIONS
Long-term resynchronization therapy results in atrial and ventricular reverse remodeling and improved hemodynamics.
Saxon
Leslie A
LA
Cardiomyopathy and Arrhythmia Research and Education Center, University of California, San Francisco, Calif, USA. saxon@medicine.ucsf.edu
De Marco
Teresa
T
Schafer
Jill
J
Chatterjee
Kanu
K
Kumar
Uday N
UN
Foster
Elyse
E
D000328:Adult; D000368:Aged; D002037:Bundle-Branch Block / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D002306:Cardiac Volume; D003971:Diastole; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D006339:Heart Rate; D006352:Heart Ventricles / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D010138:Pacemaker, Artificial; D013599:Systole; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
D009638:Norepinephrine