title: Clinical and classic echocardiographic features of patients with, and without, left ventricle reverse remodeling following the introduction of cardiac resynchronization therapy.
abstract: BACKGROUND
  The aim of the study was to assess clinical and classic echocardiographic data in patients with different cardiac resynchronization therapy (CRT) outcomes.
  
  
  METHODS
  Sixty consecutive patients (aged 66.3 ± 8.7 years, 57 men) with chronic heart failure (CHF) in New York Heart Association (NYHA) classes III-IV despite optimized pharmacotherapy, with left ventricular end-diastolic diameter (LVEDD) > 55 mm, left ventricular ejection fraction £ 35% and wide QRS complex (≥ 120 ms), including individuals with permanent atrial fibrillation (AF) and single- and dual-chamber pacing, were assessed firstly before, and secondly three months after, biventricular heart stimulator implantation (excluding three patients who died during the follow-up). Patients developing ≥ 10% reduction of left ventricular end-systolic volume (LVESV) were classified as responders to CRT.
  
  
  RESULTS
  The group of responders (n = 34, 59.7%) and the group of non-responders (n = 23, 40.3%) did not differ regarding baseline echocardiographic parameters or in terms of clinical data of age, gender, concomitant diseases, smoking or pharmacological treatment. The differences involved higher rates of ischemic CHF background, prevalence of hypertension and permanent AF, and a higher concentration of N-terminal pro-B-type natriuretic peptide (NT-proBNP) among the non-responders. In the multivariate logistic regression analysis, NT-proBNP, body mass index (BMI) and the presence of permanent AF correlated negatively with the magnitude of LVESV reduction following CRT introduction.
  
  
  CONCLUSIONS
  Classic echocardiographic data did not predict left ventricle reverse remodeling. Higher rates of ischemic CHF aetiology, hypertension, permanent AF and higher NT-proBNP concentration were found in the group without at least 10% LVESV reduction at the three month follow-up. NT-proBNP, BMI and the presence of permanent AF had negative effects on the magnitude of LVESV.
authors: 1st Department of Cardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland. putamen@interia.pl
authors: Jerzy
authors: J
authors: Wiliński
authors: Danuta
authors: D
authors: Czarnecka
authors: Wiktoria
authors: W
authors: Wojciechowska
authors: Małgorzata
authors: M
authors: Kloch-Badełek
authors: Marek
authors: M
authors: Jastrzębski
authors: Bogumiła
authors: B
authors: Bacior
authors: Tomasz
authors: T
authors: Sondej
authors: Piotr
authors: P
authors: Kusak
authors: Anna
authors: A
authors: Przybyła
authors: Kalina
authors: K
authors: Kawecka-Jaszcz
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy*; D058406:Cardiac Resynchronization Therapy / Q000379:methods*; D004452:Echocardiography / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain