title: Reversal of cardiomyopathy in patients with congestive heart failure secondary to tachycardia.
abstract: OBJECTIVE
  Tachycardia-induced cardiomyopathy (TCM) is a reversible cause of heart failure. Little is known of the characteristics of tachycardia associated with the development of left ventricular (LV) dysfunction and the reversal of cardiomyopathy after cure of tachycardia. This study aimed to examine the reversal of cardiomyopathy in patients undergoing ablation with congestive heart failure secondary to tachycardia.
  
  
  METHODS
  A total of 625 patients underwent radiofrequency ablation for tachycardiarrhymias between January 2009 and July 2011. Echocardiography analysis was performed to identify patients with depressed LV function, defined as a left ventricular ejection fraction <50 %. Patients with preexisting structural heart disease (n = 10) were excluded. NT-pro-B-type natriuretic peptide (NT-proBNP) assessment was performed before ablation in patients considered to have TCM (n = 17). Repeated echocardiography study and NT-proBNP assessment were measured after a mean follow-up of 3 months. Levels of NT-proBNP before and after ablation were compared. Reversal of cardiomyopathy was also assessed.
  
  
  RESULTS
  The incidence of TCM was 2.7 % (12 males; age, 35.8 ± 17.1 years). Successful ablation was performed in 16 of 17 patients (94.1 %). There was a significant improvement in left ventricular ejection fraction (36.7 ± 7.5 vs. 59.4 ± 9.7 %; P < 0.001). The mean left ventricular end-diastolic diameter before treatment was 59.5 ± 8.3 mm (range, 43 to 70), compared with 51.9 ± 7.4 mm (range, 40 to 67) (P = 0.009) after 3 months follow-up. The levels of NT-proBNP decreased after ablation procedure, from 4,092.6 ± 3,916.6 to 478.9 ± 881.9 pg/ml (P < 0.001). After successful ablation, ventricular function normalized in 15 of 17 (88.2 %) patients at a mean of 3 months.
  
  
  CONCLUSIONS
  Restoration of LV function and reversal of LV remodeling can be achieved with successful elimination of tachycardia in the majority of patients. NT-proBNP level elevates in subjects with TCM and decreases sharply after ablation.
authors.affiliation: Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
authors.forename: Zhao
authors.initials: Z
authors.lastname: Donghua
authors.forename: Peng
authors.initials: P
authors.lastname: Jian
authors.forename: Xiao
authors.initials: X
authors.lastname: Zhongbo
authors.forename: Zhang
authors.initials: Z
authors.lastname: Feifei
authors.forename: Peng
authors.initials: P
authors.lastname: Xinhui
authors.forename: Yang
authors.initials: Y
authors.lastname: Hao
authors.forename: Liu
authors.initials: L
authors.lastname: Fuqiang
authors.forename: Li
authors.initials: L
authors.lastname: Yan
authors.forename: Xie
authors.initials: X
authors.lastname: Yong
authors.forename: Huang
authors.initials: H
authors.lastname: Xinfu
authors.forename: Meng
authors.initials: M
authors.lastname: Surong
authors.forename: Wu
authors.initials: W
authors.lastname: Muli
authors.forename: Xu
authors.initials: X
authors.lastname: Dingli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D009202:Cardiomyopathies / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D016009:Chi-Square Distribution; D002648:Child; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D018709:Statistics, Nonparametric; D013610:Tachycardia / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain