Cardiac resynchronization therapy for the causal treatment of heart failure with preserved ejection fraction: insight from a pressure-volume loop analysis.
This case describes a middle-aged patient with normal ejection fraction (64%) and significant dyspnoea which could not be explained by results from routine examinations. A pressure-volume loop analysis revealed severe left ventricular (LV) dyssynchrony to be the underlying mechanism of heart failure. The patient underwent implantation of a biventricular pacemaker. Cardiac resynchronization therapy (CRT) was associated with an immediate reduction in LV dyssynchrony from 32 to 13%, decrease in LV end-diastolic pressure from 19 to 8 mmHg, and increased exercise tolerance during follow-up. Thus, CRT may be considered a causal therapy in selected patients with heart failure and preserved ejection fraction.
Penicka
Martin
M
Cardiovascular Center Aalst, Moorselbaan 164, Aalst, Belgium.
Kocka
Viktor
V
Herman
Dalibor
D
Trakalova
Helena
H
Herold
Martin
M
D002037:Bundle-Branch Block / Q000628:therapy*; D002304:Cardiac Pacing, Artificial; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000628:therapy*