Skoči na glavni sadržaj

Sažetak sa skupa

https://doi.org/10.15836/ccar2021.203

Echocardiographic optimization favors greater reduction in left ventricular end-diastolic volume compared to electrocardiographic optimization in patients with cardiac resynchronization therapy

Marija Brestovac orcid id orcid.org/0000-0003-1542-2890
Blanka Glavaš Konja orcid id orcid.org/0000-0003-1134-4856
Martina Lovrić Benčić orcid id orcid.org/0000-0001-8446-6120
Vlatka Rešković Lukšić orcid id orcid.org/0000-0002-4721-3236
Kristina Gašparović orcid id orcid.org/0000-0002-1191-4831
Jadranka Šeparović Hanževački orcid id orcid.org/0000-0002-3437-6407


Puni tekst: engleski pdf 167 Kb

str. 203-203

preuzimanja: 253

citiraj

Preuzmi JATS datoteku


Sažetak

Ključne riječi

cardiac resynchronization therapy; echocardiographic optimization; left ventricular volume

Hrčak ID:

257088

URI

https://hrcak.srce.hr/257088

Datum izdavanja:

4.5.2021.

Posjeta: 711 *



Introduction: Cardiac resynchronization therapy (CRT) is a widely used method in the treatment of symptomatic patients with advanced heart failure and LBBB. Its beneficial impact on the reduction of left ventricular (LV) volumes has already been shown. (1,2) The aim of this study was to determine if echocardiographic optimization of CRT pacing intervals (ECHO) after CRT device implantation has a favorable impact on LV volume change compared to electrocardiographic optimization (ECG).

Patients and Methods: An overall of 147 patients with implanted CRT according to guidelines were included in this study and divided into two groups according to the CRT optimization method (N=70 in ECG arm an N=77 in ECHO arm). ECG optimization was performed using 12-lead electrocardiogram, fusion-optimized intervals, intracardiac electrogram-based algorithms and electrocardiographic imaging. ECHO optimization implied correction of atrioventricular, inter- and intraventricular dyssynchrony using echocardiographic imaging. The change in LV end-diastolic (EDV), end-systolic (ESV) and stroke volume (SV) as well as LV ejection fraction (EF) was compared between groups, before and 6 months after CRT implantation.

Results: EDV and ESV significantly decreased and EF increased in both groups. In the ECHO a statistically significant reduction in EDV compared to ECG was present (p=0.028). According to greater EDV reduction, SV significantly decreased in ECHO (p=0.026). No significance was observed in ESV change between groups (p=0.063) (Table 1).

TABLE 1 Left ventricle volumes and ejection fraction change before and 6 months after cardiac resynchronization therapy between the analyzed groups.
ECG (N=70)ECHO (N=77)
Before CRT6 months after CRTMean change, SDBefore CRT6 months after CRTΔ
EDV (ml)218.81167.4851.32 (±64.25)231.81157.5374.28 (±80.25)p= 0.028
ESV (ml)162.27112.2550.01 (±59.38)169.67102.5767.1 (±75.02)p= 0.063
SV (ml)56.5455.231.31 (±16.46)62.1454.967.18 (±19.66)p= 0.026
EF (%)26.6736.7910.11 (±8.39)26.9739.1312.16 (±10.80)p= 0.1
EDV - left ventricular end-diastolic volume, ESV - left ventricular end-systolic volume, SV - left ventricular stroke volume, EF - left ventricular ejection fraction, SD - standard deviation.

Conclusion: ECHO optimization of CRT leads to a more significant reduction of EDV compared to ECG optimization after 6 months of follow up.

LITERATURE

1 

St John Sutton MG, Plappert T, Abraham WT, Smith AL, DeLurgio DB, Leon AR, et al. Multicenter InSync Randomized Clinical Evaluation (MIRACLE) Study Group. Effect of cardiac resynchronization therapy on left ventricular size and function in chronic heart failure. Circulation. 2003 April 22;107(15):1985–90. https://doi.org/10.1161/01.CIR.0000065226.24159.E9 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/12668512

2 

St John Sutton M, Cerkvenik J, Borlaug BA, Daubert C, Gold MR, Ghio S, et al. Effects of Cardiac Resynchronization Therapy on Cardiac Remodeling and Contractile Function: Results From Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction (REVERSE). J Am Heart Assoc. 2015 September 11;4(9):e002054. https://doi.org/10.1161/JAHA.115.002054 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/26363005


This display is generated from NISO JATS XML with jats-html.xsl. The XSLT engine is libxslt.