Key result
Pre-implant right ventricular systolic maximal velocity significantly predicted the short-term postoperative increase in left ventricular contractility following cardiac resynchronization therapy.
Why the study?
Does pre-implant right ventricular systolic function predict echocardiographic response to cardiac resynchronization therapy in patients with severe heart failure?
Cohort (n=22)
No
Does pre-implant right ventricular systolic function predict echocardiographic response to cardiac resynchronization therapy in patients with severe heart failure?
Pre-implant right ventricular systolic dysfunction, assessed by tissue Doppler imaging, may predict poor short-term echocardiographic response to cardiac resynchronization therapy.
Answers are grounded in this paper and cite their sources.
RV velocity may aid short-term CRT response prediction; leaves open whether it should guide selection pending prospective validation.
OBJECTIVE: Cardiac resynchronization therapy is proven efficacious in patients with heart failure (HF). Presence of biventricular HF is associated with a worse prognosis than having only left ventricular (LV) HF and pacing might deteriorate heart function. The aim of the study was to assess a possible significance of right ventricular (RV) pre-implant systolic function to predict response to CRT. DESIGN: We studied 22 HF-patients aged 72 ± 11 years, QRS-duration 155 ± 20 ms and with an LV ejection fraction (EF) of 26 ± 6% before and four weeks after receiving a CRT-device. RESULTS: There were no changes in LV diameters or end systolic volume (ESV) during the study. However, end diastolic volume (EDV) decreased from 226 ± 71 to 211 ± 64 ml (p = 0.02) and systolic maximal velocities (SMV) increased from 2.2 ± 0.4 to 2.6 ± 0.9 cm/s (p = 0.04). Pre-implant RV-SMV (6.2 ± 2.6 cm/s) predicted postoperative increase in LV contractility, p = 0.032. CONCLUSIONS: Pre-implant decreased RV systolic function might be an important way to predict a poor response to CRT implicating that other treatments should be considered. Furthermore we found that 3D- echocardiography and Tissue Doppler Imaging were feasible to detect short-term changes in LV function.
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Edner et al. (2011) conducted a cohort in Heart Failure (n=22). Cardiac Resynchronization Therapy (CRT) vs. Pre-implantation baseline was evaluated on Change in left ventricular systolic maximal velocity (LV-SMV) predicted by pre-implant right ventricular systolic maximal velocity (RV-SMV) (Coefficient 0.25, 95% CI 0.024-0.47, p=0.032). Pre-implant right ventricular systolic maximal velocity significantly predicted the short-term postoperative increase in left ventricular contractility following cardiac resynchronization therapy.
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