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Cardiologia Croatica, Vol. 18 No. 5-6, 2023.

Meeting abstract

https://doi.org/10.15836/ccar2023.139

Additional benefit of echocardiographic optimization of cardiac resynchronization therapy devices according to specific echocardiographic and clinical parameters

Marija Brestovac orcid id orcid.org/0000-0003-1542-2890 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Blanka Glavaš Konja orcid id orcid.org/0000-0003-1134-4856 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Martina Lovrić Benčić orcid id orcid.org/0000-0001-8446-6120 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Vlatka Rešković Lukšić orcid id orcid.org/0000-0002-4721-3236 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Sandra Jakšić Jurinjak orcid id orcid.org/0000-0002-7349-6137 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Joško Bulum orcid id orcid.org/0000-0002-1482-6503 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Zvonimir Ostojić orcid id orcid.org/0000-0003-1762-9270 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Kristina Gašparović orcid id orcid.org/0000-0002-1191-4831 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Jadranka Šeparović Hanževački orcid id orcid.org/0000-0002-3437-6407 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia

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Abstract

Keywords

cardiac resynchronization therapy optimization; echocardiographic optimization; myocardial dyssynchrony

Hrčak ID:

301174

URI

https://hrcak.srce.hr/301174

Publication date:

27.4.2023.

Visits: 433 *

Copyright: 2023, Croatian Cardiac Society

Date received: 25 March 2023

Date accepted: 29 March 2023

Publication date (print and electronic): April 2023

Volume: 18

Issue: 5-6

Page: 139

Publisher ID: CC 2022 18_5-6_139

DOI: 10.15836/ccar2023.139

Article Information (continued)

Categories:

Subject: Extended Abstract

KEYWORDS: :

KEYWORDS:

Keyword: cardiac resynchronization therapy optimization

Keyword: echocardiographic optimization

Keyword: myocardial dyssynchrony

Additional benefit of echocardiographic optimization of cardiac resynchronization therapy devices according to specific echocardiographic and clinical parameters

[https://orcid.org/0000-0003-1542-2890] Marija Brestovac[*]

[https://orcid.org/0000-0003-1134-4856] Blanka Glavaš Konja

[https://orcid.org/0000-0001-8446-6120] Martina Lovrić Benčić

[https://orcid.org/0000-0002-4721-3236] Vlatka Rešković Lukšić

[https://orcid.org/0000-0002-7349-6137] Sandra Jakšić Jurinjak

[https://orcid.org/0000-0002-1482-6503] Joško Bulum

[https://orcid.org/0000-0003-1762-9270] Zvonimir Ostojić

[https://orcid.org/0000-0002-1191-4831] Kristina Gašparović

[https://orcid.org/0000-0002-3437-6407] Jadranka Šeparović Hanževački

 

University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia

Author notes:

Correspondence to: [*] ADDRESS FOR CORRESPONDENCE: Marija Brestovac, Klinički bolnički centar Zagreb, Kišpatićeva 12, HR-10000 Zagreb, Croatia. / Phone: +385-99-7742-627 / E-mail: marija.brestovac@gmail.com

Introduction: Cardiac resynchronization therapy (CRT) contributes to left ventricle ejection fraction and NYHA improvement in patients with severe heart failure. In literature, echocardiographic (ECHO) benefits of CRT were found in a wide spectrum of different ECHO parameters. (1-4) In this study we compared ECHO benefit of echocardiographic optimization of CRT device with the standard, ECG method in a spectrum of different ECHO parameters.

Patients and Methods: An overall of 146 patients were analyzed according to the method of CRT optimization. The first group (OPT) was optimized by ECHO signs of dyssynchrony whereas the second group (ECG) was analyzed using QRS duration. Changes in QRS duration, NYHA, left ventricle end-systolic volume (ΔESV), end-diastolic volumen (ΔEDV), ejection fraction (ΔEF), global longitudinal strain (GLS), mean pulmonary artery pressure (PAP), mitral regurgitation (MR), ΔNTproBNP, septal flash (SF), atrioventricular dyssynchrony (AVd), interventricular dyssynchrony using difference in onset of pulmonary and aortic ejection (PV/AV) and quality of life using SF-36 questionnaire were compared between the groups in a follow up period of 6 months.

Results: No additional benefit of one group over the other was found for QRS duration reduction (p=0.366), NYHA (p=0.221), ΔESV (p=0.093), ΔEF (p=0.218), GLS (p=0.665), MR (p=0.278), PAP (p=0.433) and QoL (p=0.213) whereas a faster and higher reduction in ΔEDV (p=0.045), ΔNTproBNP (p=0.037), SF (p=0.0014), AVd (p=0.002), PV/AV (p=0.041) was found in OPT group favoring ECHO optimization.

Conclusion: Echocardiographic optimization of CRT contributes to an additional echocardiographic benefit over the standard method in reduction of NTproBNP, ΔEDV and SF, AVd and PV/AV.

LITERATURE

1 

Gallard A, Bidaut A, Hubert A, Sade E, Marechaux S, Sitges M, et al. Characterization of Responder Profiles for Cardiac Resynchronization Therapy through Unsupervised Clustering of Clinical and Strain Data. J Am Soc Echocardiogr. 2021 May;34(5):483–93. https://doi.org/10.1016/j.echo.2021.01.019 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/33524492

2 

Stephansen C, Kronborg MB, Witt CT, Kristensen J, Gerdes C, Sommer A, et al. Reproducibility of measuring QRS duration and implications for optimization of interventricular pacing delay in cardiac resynchronization therapy. Ann Noninvasive Electrocardiol. 2019 May;24(3):e12621. https://doi.org/10.1111/anec.12621 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/30521128

3 

van der Bijl P, Khidir M, Ajmone Marsan N, Delgado V, Leon MB, Stone GW, et al. Effect of Functional Mitral Regurgitation on Outcome in Patients Receiving Cardiac Resynchronization Therapy for Heart Failure. Am J Cardiol. 2019 January 1;123(1):75–83. https://doi.org/10.1016/j.amjcard.2018.09.020 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/30539749

4 

Calle S, Delens C, Kamoen V, De Pooter J, Timmermans F. Septal flash: At the heart of cardiac dyssynchrony. Trends Cardiovasc Med. 2020 February;30(2):115–22. https://doi.org/10.1016/j.tcm.2019.03.008 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/31000325

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