Key result
CRT linked to improved diastolic function and a ~27% lower E/E' ratio at 6 months.
Why the study?
While systolic function improvements after CRT are well established, its effect on left ventricular diastolic function remains variable and not well established.
Does Cardiac Resynchronization Therapy (CRT) improve left ventricular diastolic functions in patients with heart failure?
Observational (n=67)
No
Does Cardiac Resynchronization Therapy (CRT) improve left ventricular diastolic functions in patients with heart failure?
Absolute Event Rate: 11.94% vs 16.33%
p-value: p=0.0001
Cardiac Resynchronization Therapy significantly improves left ventricular diastolic functions in patients who are systolic responders, but not in non-responders.
CRT-associated diastolic gains in systolic responders support hypothesis generation; prospective RCTs needed before practice change.
Improvement in systolic functions after CRThas been well-established, but the effect on Left Ventricular (LV) diastolic functions is variable and not well established. The aim of this study is to analyze the improvement in diastolic functions of the heart after CRT. Total 67 cases of Heart Failure (HF) eligible for CRT (mean age, 62.5 ± 11.73 years; 54 males and 13 females) with Left Ventricular Ejection Fraction (LVEF) ≤35% or New York Heart Association (NYHA) Class II, III / Ambulatory IV (IVA) were included in the study. LVEF, pulsed-wave Doppler (PWD) derived transmitral filling indices (E and A wave velocities, E/A ratio), and peak early diastolic longitudinal myocardial velocity (E´) wave by tissue doppler were measured pre and post CRT and were compared. Left Ventricular Ejection Fraction (LVEF) increased >5% (responders) in 42 of 67 patients (62.6%) which was also associated with a reduction in pulsed-wave Doppler (PWD) derived indices that is E velocity, E/A ratio and E/E’ ratio while in non-responders (LVEF<5%) the E velocity, E/A ratio, E’ did not show significant change but E/E’ reduced significantly after CRT. Left Ventricular Diastolic functions improved significantly after CRT in responders but not in non responders.
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Mujeeb et al. (2021) conducted an observational in Heart Failure (n=67). Cardiac Resynchronization Therapy (CRT) vs. Baseline was evaluated on E/E' ratio at 6 months (p=0.0001). Cardiac Resynchronization Therapy significantly improved left ventricular diastolic function, reducing the E/E' ratio from 16.33 at baseline to 11.94 at 6 months (p=0.0001).
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