title: Improvement in right ventricular systolic function after cardiac resynchronization therapy correlates with left ventricular reverse remodeling.
abstract: BACKGROUND
  Cardiac resynchronization therapy (CRT) improves left ventricular (LV) systolic function in heart failure (HF). However, the effects of CRT on right ventricular (RV) systolic function are not fully understood.
  
  
  OBJECTIVE
  We aimed to determine echocardiographic correlates of improvement in RV systolic function after CRT.
  
  
  METHODS
  Fifty-four patients (61.9 ± 10.5 years; 43 men; LV ejection fraction 24.6 ± 4.0%; QRS duration > 120 ms) with HF were enrolled. Standard echocardiography, strain rate (SR), and tissue Doppler imaging were performed in all patients before and 6 months after CRT. Pulsed-wave TDI-derived systolic indices of RV included systolic (RV(S) ) and isovolumic velocity (RV(IVV)) and isovolumic acceleration (RV(IVA)). Response to CRT was defined as decline in LV end-systolic volume (LVESV) ≥ 10%.
  
  
  RESULTS
  When indices of RV systolic function were assessed between responders and nonresponders, in responders (38 patients, 70.4%) RV end-diastolic diameters (RVD1-3), mid-RV strain, and mid-RV SR improved significantly (P < 0.01, for all). RV(S) (10.77 ± 4.29 vs 12.62 ± 4.10 cm/sec, P = 0.005), RV(IVV) (14.71 ± 5.88 vs 18.52 ± 6.62 cm/sec, P < 0.001), and RV(IVA) (1.69 ± 0.70 vs 2.39 ± 0.77 m/sec(2) , P < 0.001) significantly increased among responders. There was no significant change in these parameters among nonresponders. Pearson's analyses revealed moderate positive correlations between reduction of LVESV and ΔRV(IVV) (r = 0.467, P = 0.001) and ΔRV(IVA) (r = 0.473, P = 0.001), respectively.
  
  
  CONCLUSIONS
  RV diameters and systolic indices after CRT improved only in the responder group. Improvement in RV systolic performance after CRT is correlated with the reduction of LVESV.
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Aksoy
authors.forename: Sercan
authors.initials: S
authors.lastname: Okutucu
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
authors.forename: Ergun Baris
authors.initials: EB
authors.lastname: Kaya
authors.forename: Erol
authors.initials: E
authors.lastname: Tulumen
authors.forename: Banu
authors.initials: B
authors.lastname: Evranos
authors.forename: Sefik Görkem
authors.initials: SG
authors.lastname: Fatihoglu
authors.forename: Giray
authors.initials: G
authors.lastname: Kabakci
authors.forename: Lale
authors.initials: L
authors.lastname: Tokgozoglu
authors.forename: Hilmi
authors.initials: H
authors.lastname: Ozkutlu
authors.forename: Ali
authors.initials: A
authors.lastname: Oto
mesh_terms: D058406:Cardiac Resynchronization Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013223:Statistics as Topic; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000175:diagnosis / Q000517:prevention & control*; D018497:Ventricular Dysfunction, Right / Q000150:complications* / Q000175:diagnosis / Q000517:prevention & control*; D020257:Ventricular Remodeling