Echocardiographic evaluation of patients with severe heart failure and impairment of intraventricular conduction following cardiac resynchronisation therapy.
BACKGROUND
Echocardiographic examination is essential for clinical assessment of patients after cardiac resynchronisation therapy (CRT).


OBJECTIVE
To assess the benefit of CRT in patients with end-stage heart failure at long-term follow-up.


METHODS
28 patients with end-stage heart failure, NYHA class >or= III (>or= II in patients with indications for implantable cardioverter defibrillator and echocardiographic signs of ventricular mechanical systolic dyssynchrony), left ventricular ejection fraction (LVEF) <35%, QRS duration >120 ms and left bundle branch block morphology received a biventricular device. Standard colour Doppler echocardiography examination was performed at baseline, and then every 6 months, up to 2 years. Parameters of systolic and diastolic LV function, mitral insufficiency and right ventricular (RV) pressure were evaluated.


RESULTS
Following CRT, a statistically significant improvement of LV dimensions (p<0.05), and LVEF (p<0.001) was recorded. CRT also resulted in a mitral regurgitation decrement (p<0.01). Interventricular mechanical delay was shortened (p=0.0005). After 2 years, non-significant worsening of LV dimensions was observed. At long-term follow-up CRT did not result in LV volume, left atrium, RV dimension or RV pressure reduction.


CONCLUSIONS
CRT is associated with reverse remodelling of the LV at mid-term follow-up.
Faran
Anna
A
Department of Cardiology and Heart Electrotherapy, Medical University, Gdańsk, Poland. anfar@wp.pl
Dabrowska-Kugacka
Alicja
A
Lewicka-Nowak
Ewa
E
Tybura
Sebastian
S
Zieba
Bozena
B
Daniłowicz-Szymanowicz
Ludmiła
L
Krzymińska-Stasiuk
Elzbieta
E
Kempa
Maciej
M
Kogut
Katarzyna
K
Raczak
Grzegorz
G
D000328:Adult; D000368:Aged; D002304:Cardiac Pacing, Artificial; D005260:Female; D006329:Heart Conduction System; D006333:Heart Failure / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D012720:Severity of Illness Index; D014463:Ultrasonography; D020257:Ventricular Remodeling