Europace Advance Access published online on January 28, 2008
Europace, doi:10.1093/europace/eum297
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Chronic cardiac resynchronization therapy reverses cardiac remodelling and improves invasive haemodynamics of patients with severe heart failure on optimal medical treatment
Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan
Aims: The aim of this study was to assess chronic invasive haemodynamic effects of cardiac resynchronization therapy (CRT) in patients with severe heart failure.
Methods and results: Seventeen patients with New York Heart Association (NYHA) class III or IV and QRS duration >120 ms on optimal treatments underwent CRT. Haemodynamic data were obtained by cardiac catheterization before and 1 month after CRT. Clinical parameters and exercise tolerance were also evaluated. Chronic CRT improved haemodynamics significantly; mean pulmonary capillary wedge pressure decreased from 15.9 ± 6.1 to 10.2 ± 5.3 mmHg (P < 0.05), systolic pulmonary artery pressure decreased from 36.5 ± 13.2 to 26.7 ± 11.9 mmHg (P < 0.05), left ventricular end-diastolic pressure decreased from 15.6 ± 7.2 to 10.5 ± 7.3 mmHg (P < 0.05), end-diastolic volume decreased from 358.8 ± 84.6 to 322.9 ± 99.0 mL (P < 0.05), end-systolic volume decreased from 264.1 ± 67.6 to 219.2 ± 74.3 mL (P < 0.05), left ventricular ejection fraction increased from 25.4 ± 6.2 to 33.1 ± 4.9% (P < 0.05), and cardiac index increased from 1.9 ± 0.4 to 2.2 ± 0.5 L/min/m2 (P < 0.05). Chronic CRT significantly improved functional capacity such as NYHA classification, 6 min walk distance, and peak oxygen uptake.
Conclusion: Chronic CRT improved not only symptoms and exercise tolerance but also invasive haemodynamics associated with reversed cardiac remodelling.
Key Words: Resynchronization, Haemodynamic effect, Cardiac catheterization, Reverse cardiac remodelling
* Corresponding author. Tel: +81 942 31 7562; fax: +81 942 33 6509. E-mail address: teruhisa{at}med.kurume-u.ac.jp
Manuscript submitted 18 June 2007. Accepted after revision 18 December 2007.
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