Lipoldova, Jolana; Ozabalova, Eva; Meluzin, Jaroslav; Novak, Miroslav; Vitovec, Jiri
March 2010
Biomedical Papers of the Medical Faculty of Palacky University i;2010, Vol. 154 Issue 1, p39
Academic Journal
Background. A number of trials have demonstrated the effect of cardiac resynchronization therapy (CRT) on functional improvement and reversed left ventricle remodeling. Meeting contemporary guidelines approximately 30- 40% of patients do not respond to CRT (non-responders). Aim. To quantify the predictive ability of basal QRS width and basal echocardiographic parameters of left ventricle contraction dyssynchrony in our group of CRT patients. To compare effectiveness of these parameters assessment in patients with ischemic (iCMP) and non-ischemic cardiomyopathy (niCMP) and with sinus rhythm (SR) and atrial fibrillation (AF). Patients and methods. 194 patients after successful introduction of CRT device were evaluated. Evaluation of NYHA function class, QRS width and echocardiographic parameters including parameters of left ventricle contraction dyssynchrony (SPWMD: septal-to-posterior wall motion delay, Ts-sep-lat: time interval between maximum of systolic movement of septum and lateral wall using tissue Doppler imaging, IVMD: interventricular mechanical delay) performed before implantation and 3 months after implantation of CRT device. Results. Responder (improved in NYHA class after CRT) rate was 61%. SR patients showed higher benefit compared to AF patients (responder rate 63% vs. 52%, p<0.05). Narrowing of QRS width after CRT was observed only in responders. SPWMD and Ts-sep-lat decreased after CRT in all subgroups. SPWMD dyssynchrony (SPMWD ≥ 130 ms) reduction after CRT was more expressed in niCMP population. Ts-sep-lat dyssynchrony (Ts-sep-lat ≥ 65 ms) reduction after CRT was more expressed in SR patients. IVMD (IVMD ≥ 60 ms) remained unchanged in average, but significant decrease was observed in responders and significant increase in non-responders. QRS width, SPWMD and Ts-sep-lat showed moderate sensitivity but poor specificity to predict CRT benefit. QRS width ≥ 150 ms in niCMP patients showed higher sensitivity to predict CRT effect compared to iCMP patients (91%, 65% respectively). IVMD showed poor sensitivity but good specificity to predict CRT benefit. IVMD in SR patients (compared to AF patients) showed higher specificity to predict CRT effect (90%, 63% respectively). Conclusion. None of tested left ventricle contraction dyssynchrony parameters showed good sensitivity and specificity to predict CRT benefit. QRS width as a predictor factor was more beneficial in non-ischemic patients and IVMD in sinus rhythm patients.


Related Articles

  • Biventricular diastolic behaviour in patients with hypertrophic and hereditary hemochromatosis cardiomyopathies. Palka, Przemysław; Lange, Aleksandra; Atherton, John; Stafford, Wayne J.; Burstow, Darryl J. // European Journal of Echocardiography;2004, Vol. 5 Issue 5, p356 

    Aim: To define biventricular diastolic behaviour in patients with cardiomyopathies with predominant diastolic left ventricular (LV) dysfunction.Methods and results: Doppler tissue echocardiography and both mitral and tricuspid Doppler inflow profiles were investigated in hypertrophic (n = 17),...

  • Isolated non-compaction of the left ventricle. Kshirsagar, V. Y.; Ahmed, M.; Colaco, S. M.; Patil, S. V. // South African Journal of Child Health;Sep2014, Vol. 8 Issue 3, p117 

    Isolated left ventricular non-compaction (LVNC) is a rare congenital disorder caused by failure of normal embryogenesis of the endocardium and myocardium in utero, resulting in prominent ventricular trabeculations with deep intertrabecular recesses. Patients may be asymptomatic or may present...

  • Outcome prediction in heart failure with atrial fibrillation: Relative role of left ventricular ejection fraction and neurohormonal measures. Clements, Ian; Wiseman, Gregory; Hodge, David; Jacobson, Arnold // Journal of Nuclear Cardiology;Oct2013, Vol. 20 Issue 5, p821 

    Background: Since atrial fibrillation (AF) impacts the measurement and interpretation of left ventricular ejection fraction (LVEF), we hypothesized that the outcome in heart failure (HF) with AF and LVEF ≤ 35% would be more strongly associated with neurohormonal measures than LVEF. Methods...

  • Cardiac Transplantation in Friedreich Ataxia. Yoon, Grace; Soman, Teesta; Wilson, Judith; George, Kristen; Mital, Seema; Dipchand, Anne I.; McCabe, Jane; Logan, William; Kantor, Paul // Journal of Child Neurology;Sep2012, Vol. 27 Issue 9, p1193 

    In this article, we describe a 14-year-old boy with a confirmed diagnosis of Friedreich ataxia who underwent cardiac transplantation for left ventricular failure secondary to dilated cardiomyopathy with restrictive physiology. His neurological status prior to transplantation reflected early...

  • Implantation of Left Ventricular Assist Device. Szarszoi, Ondrej; Maly, Jiri; Turek, Daniel; Urban, Marian; Skalsky, Ivo; Riha, Hynek; Maluskova, Jana; Pirk, Jan; Netuka, Ivan // Texas Heart Institute Journal;2012, Vol. 39 Issue 5, p615 

    A patient with dilated cardiomyopathy and no history of thromboembolic events received a surgically implanted axial-flow left ventricular assist device. After implantation, transesophageal echocardiography revealed a giant thrombus on the lateral and anterior aspects of the left ventricle. The...

  • Right ventricular dilatation predicts survival after mitral valve repair in patients with impaired left ventricular systolic function. Anton Chrustowicz; Gregor Simonis; Klaus Matschke; Ruth H. Strasser; Andrzej Gackowski // European Journal of Echocardiography;Mar2009, Vol. 10 Issue 2, p309 

    Aims The prognostic value of the right ventricular parameters in patients with heart failure (HF) is well documented, but the data on patients undergoing mitral valve repair are lacking. Methods and results The association between pre-operative right ventricular dilatation and outcome was...

  • Influence of Diabetes on Left Ventricular Systolic and Diastolic Function and on Long-Term Outcome After Cardiac Resynchronization Therapy. HÖKE, ULAS; THIJSSEN, JOEP; VAN BOMMEL, RUTGER J.; VAN ERVEN, LIESELOT; VAN DER VELDE, ENNO T.; HOLMAN, EDUARD R.; SCHALIJ, MARTIN J.; BAX, JEROEN J.; DELGADO, VICTORIA; MARSAN, NINA AJMONE // Diabetes Care;Apr20123, Vol. 36 Issue 4, p985 

    OBJECTIVE--The influence of diabetes on cardiac resynchronization therapy (CRT) remains unclear. The aims of the current study were to 1) assess the changes in left ventricular (LV) systolic and diastolic function and 2) evaluate long-term prognosis in CRT recipients with diabetes. RESEARCH...

  • Building a bridge to recovery: the pathophysiology of LVAD-induced reverse modeling in heart failure. Miyagawa, Shigeru; Toda, Koichi; Nakamura, Teruya; Yoshikawa, Yasushi; Fukushima, Satsuki; Saito, Shunsuke; Yoshioka, Daisuke; Saito, Tetsuya; Sawa, Yoshiki // Surgery Today;Feb2016, Vol. 46 Issue 2, p149 

    Heart failure mainly caused by ischemic or dilated cardiomyopathy is a life-threatening disorder worldwide. The previous work in cardiac surgery has led to many excellent surgical techniques for treating cardiac diseases, and these procedures are now able to prolong the human lifespan. However,...

  • Value of assessment of left atrial volume and diameter in patients with heart failure but with normal left ventricular ejection fraction and mitral flow velocity pattern. Chikako Yoshida; Shinji Nakao; Akiko Goda; Yoshiro Naito; Mika Matsumoto; Misato Otsuka; Miho Shimoshikiryo; Akiyo Eguchi; Masaaki Lee-Kawabata; Takeshi Tsujino; Tohru Masuyama // European Journal of Echocardiography;Mar2009, Vol. 10 Issue 2, p278 

    Aims We assessed the comparative value of measurements of tissue Doppler early diastolic mitral annular velocity (E′), left atrial diameter (LAD), and left atrial volume (LAV) in patients with possible heart failure (HF) but with normal left ventricular (LV) ejection fraction (EF) and...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics