title: Echocardiographic assessment during exercise of heart failure patients with cardiac resynchronization therapy.
abstract: This prospective echocardiographic study investigated the respective impacts of left ventricular (LV) pacing and simultaneous and sequential biventricular pacing (BVP) on ventricular dyssynchrony during exercise in 23 patients with compensated heart failure and ventricular conduction delays. During exercise, LV pacing and BVP significantly (p <0.05) improved mitral regurgitation and LV dyssynchrony compared with spontaneous activation. LV segmental electromechanical delays were significantly prolonged during LV pacing, leading to increased systolic time (p <0.05), decreased LV filling time (p <0.05), and decreased stroke volume (p <0.05) compared with BVP. After optimization of the interventricular delay with sequential BVP, additional benefit was obtained during exercise in terms of stroke volume and mitral regurgitation (p <0.05). The optimal interventricular delay was different at rest and during exercise in 57% of the patients. Changes from at rest to exercise in LV dyssynchrony were correlated with changes in stroke volume (r = -0.61, p <0.01) and changes in mitral regurgitation (r = 0.60, p <0.01).
authors.affiliation: Cardiologic Hospital, Pessac and Bordeaux 2 University, Pessac, France. bordacharp@hotmail.com
authors.forename: Pierre
authors.initials: P
authors.lastname: Bordachar
authors.forename: Stephane
authors.initials: S
authors.lastname: Lafitte
authors.forename: Sylvain
authors.initials: S
authors.lastname: Reuter
authors.forename: Karim
authors.initials: K
authors.lastname: Serri
authors.forename: Stephane
authors.initials: S
authors.lastname: Garrigue
authors.forename: Julien
authors.initials: J
authors.lastname: Laborderie
authors.forename: Patricia
authors.initials: P
authors.lastname: Reant
authors.forename: Pierre
authors.initials: P
authors.lastname: Jais
authors.forename: Michel
authors.initials: M
authors.lastname: Haissaguerre
authors.forename: Raymond
authors.initials: R
authors.lastname: Roudaut
authors.forename: Jacques
authors.initials: J
authors.lastname: Clementy
mesh_terms: D002304:Cardiac Pacing, Artificial; D004452:Echocardiography; D004554:Electric Countershock; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005500:Follow-Up Studies; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D009200:Myocardial Contraction; D011379:Prognosis; D011446:Prospective Studies