Cardiac resynchronization therapy significantly increased left atrial total emptying fraction from 33% to 41% and reduced the frequency of spontaneous echo contrast from 90% to 45% over 6 months.
Observational (n=20)
Single-blind
No
Does cardiac resynchronization therapy improve left atrial reverse remodeling, left atrial total emptying fraction, and spontaneous echo contrast in patients with systolic heart failure and complete left bundle-branch block?
Cardiac resynchronization therapy induces left atrial reverse remodeling, improves left atrial emptying fraction, and reduces spontaneous echo contrast in patients with systolic heart failure and complete left bundle-branch block.
Absolute Event Rate: 41% vs 33%
p-value: p=0.04
Recent studies revealed reverse remodeling in left ventricle with cardiac resynchronization therapy (CRT). However, effects on left atrial remodeling, left atrial total emptying fraction and left atrial spontaneous echo contrast (SEC) have not been adequately evaluated. The aim of this study was to investigate the long-term changes in SEC, left atrial reverse remodeling, and left atrial total emptying fraction after CRT. Twenty patients with systolic heart failure and complete left bundle-branch block underwent implantation of biventricular pacemaker devices. Transthoracic and transesophageal echocardiography were performed one week before and one and six months after pacemaker implantation. After biventricular pacemaker implantation, significant clinical improvement was observed in all patients. Left atrial maximal and minimal volumes showed a significant progressive decline after CRT (reverse remodeling). Left atrial total emptying ejection fraction (LATEF) was 33 +/- 19% at baseline and increased to 37 +/- 10% and 41 +/- 11% at the 1st and 6th months respectively (p = 0.01 and p = 0.04). SEC was detected in 18 of 20 patients (90%) at the beginning of the study. After six months SEC disappeared in 5 patients and frequency of SEC reduced to 45%. Decrease in the intensity of the SEC was also statistically significant (at the 1st and 6th months; p = 0.001 and p < 0.001 respectively). Long-term CRT results in atrial reverse remodeling, increases LATEF, and reduces both frequency and intensity of atrial SEC.
Vural et al. (Thu,) conducted a observational in Dilated cardiomyopathy with left bundle-branch block (n=20). Cardiac Resynchronization Therapy (biventricular pacemaker) vs. Baseline was evaluated on Left atrial total emptying fraction (LATEF) at 6 months (p=0.04). Cardiac resynchronization therapy significantly increased left atrial total emptying fraction from 33% to 41% and reduced the frequency of spontaneous echo contrast from 90% to 45% over 6 months.
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