title: Relationship Between Reverse Remodeling and Cardiopulmonary Exercise Capacity in Heart Failure Patients Undergoing Cardiac Resynchronization Therapy.
abstract: BACKGROUND
  Studies on the relationship between left ventricular reverse remodeling and cardiopulmonary exercise capacity in heart failure patients undergoing cardiac resynchronization therapy (CRT) are scarce and inconclusive.
  
  
  RESULTS
  Eighty-four patients with a 1st-time CRT-defibrillator (mean age 65 ± 11; 73% male) underwent echocardiography and cardiopulmonary exercise testing (CPX) before implantation (baseline) and 6 months after implantation. At baseline, patients also completed a set of questionnaires measuring mental and physical health. The association between echocardiographic response (left ventricular end-systolic volume decrease ≥15%) and a comprehensive set of CPX results was examined. Echocardiographic responders (54%) demonstrated higher peak oxygen consumption and better exercise performance than nonresponders at baseline and at 6-month follow-up. Furthermore, only echocardiographic responders showed improvements in ventilatory efficiency during follow-up. Multivariable repeated measures analyses revealed that, besides reverse remodeling, New York Heart Association functional class II and good patient-reported health status before implantation were the most important correlates of higher average oxygen consumption during exercise, and that nonischemic etiology and smaller pre-implantation QRS width were associated with better ventilatory efficiency over time.
  
  
  CONCLUSIONS
  During the first 6 months of CRT there was a significant positive association between reverse remodeling and cardiopulmonary exercise capacity.
authors.affiliation: Department of Cardiology, University Medical Center, Utrecht, The Netherlands; Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands. Electronic address: mmasten2@umcutrecht.nl.
authors.forename: Mirjam H
authors.initials: MH
authors.lastname: Mastenbroek
authors.affiliation: Department of Cardiology, University Medical Center, Utrecht, The Netherlands.
authors.forename: Jetske
authors.initials: J
authors.lastname: Van't Sant
authors.affiliation: Department of Cardiology, University Medical Center, Utrecht, The Netherlands; Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands.
authors.forename: Henneke
authors.initials: H
authors.lastname: Versteeg
authors.affiliation: Department of Cardiology, University Medical Center, Utrecht, The Netherlands.
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Cramer
authors.affiliation: Department of Cardiology, University Medical Center, Utrecht, The Netherlands.
authors.forename: Pieter A
authors.initials: PA
authors.lastname: Doevendans
authors.affiliation: Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands; Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Cardiology, Odense University Hospital, Odense, Denmark; Department of Psychology, University of Southern Denmark, Odense, Denmark.
authors.forename: Susanne S
authors.initials: SS
authors.lastname: Pedersen
authors.affiliation: Department of Cardiology, University Medical Center, Utrecht, The Netherlands.
authors.forename: Mathias
authors.initials: M
authors.lastname: Meine
mesh_terms: D000368:Aged; D058406:Cardiac Resynchronization Therapy; D017147:Defibrillators, Implantable; D004452:Echocardiography; D004562:Electrocardiography; D005080:Exercise Test; D005081:Exercise Therapy; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D000071066:Patient Reported Outcome Measures; D012123:Pulmonary Ventilation; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology; D020257:Ventricular Remodeling / Q000502:physiology*
keywords: Cardiac resynchronization therapy; exercise capacity; heart failure; reverse remodeling