title: Effects of cardiac resynchronization therapy on diastolic function: evaluation by radionuclide angiography.
abstract: While the beneficial effects of cardiac resynchronization therapy (CRT) on left ventricular (LV) systolic function have been demonstrated, no information is available regarding its effects on LV diastolic function during exercise. Using radionuclide angiography, we prospectively evaluated the effects of CRT on diastolic function at rest and during exercise in 15 patients consecutively referred for CRT. All patients underwent equilibrium Tc(99) radionuclide angiography with bicycle exercise performed (1) at baseline; (2) immediately after CRT implantation, in spontaneous rhythm and during CRT; and (3) after 3 months of biventricular stimulation. Diastolic function was assessed by measurements of peak filling rate (PFR). At baseline, activation of biventricular stimulation influenced PFR neither at rest (1.06 +/- 0.34 vs 1.07 +/- 0.50 mL/s during spontaneous rhythm, P = 0.9) nor during exercise (1.45 +/- 0.62 vs 1.33 +/- 0.48 mL/s, P = 0.3). At 3 months, improvements were observed in New York Heart Association functional class and systolic function. By contrast, no improvement in diastolic function was observed either at rest (PFR = 1.11 +/- 0.45 vs 1.07 +/- 0.50 mL/s in spontaneous rhythm at baseline, P = 0.6) or during exercise (1.23 +/- 0.50 vs 1.33 +/- 0.48 mL/s, P = 0.2). These observations indicate that the intermediate benefits conferred by CRT on LV systolic function at rest and during exercise were not accompanied by similar improvements in diastolic function.
authors.affiliation: Institute of Cardiology, University of Bologna, Bologna, Italy. giuseppe.boriani@unibo.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Boriani
authors.forename: Cinzia
authors.initials: C
authors.lastname: Valzania
authors.forename: Francesco
authors.initials: F
authors.lastname: Fallani
authors.forename: Mauro
authors.initials: M
authors.lastname: Biffi
authors.forename: Cristian
authors.initials: C
authors.lastname: Martignani
authors.forename: Davide
authors.initials: D
authors.lastname: Saporito
authors.forename: Matteo
authors.initials: M
authors.lastname: Ziacchi
authors.forename: Igor
authors.initials: I
authors.lastname: Diemberger
authors.forename: Cristiano
authors.initials: C
authors.lastname: Greco
authors.forename: Matteo
authors.initials: M
authors.lastname: Bertini
authors.forename: Giulia
authors.initials: G
authors.lastname: Domenichini
authors.forename: Maurizio
authors.initials: M
authors.lastname: Levorato
authors.forename: Roberto
authors.initials: R
authors.lastname: Franchi
authors.forename: Angelo
authors.initials: A
authors.lastname: Branzi
mesh_terms: D000368:Aged; D002304:Cardiac Pacing, Artificial; D003971:Diastole; D004562:Electrocardiography; D017079:Exercise Tolerance; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011875:Radionuclide Angiography; D016896:Treatment Outcome; D016277:Ventricular Function, Left