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Prognostic significance of improvement in right ventricular systolic function during cardiac resynchronization therapy.
- Source :
-
Acta cardiologica [Acta Cardiol] 2017 Jun; Vol. 72 (3), pp. 267-275. Date of Electronic Publication: 2017 Mar 31. - Publication Year :
- 2017
-
Abstract
- Objectives There is conflicting evidence concerning the role of right ventricular (RV) systolic dysfunction in the long-term clinical outcome after cardiac resynchronization therapy (CRT). Therefore we aimed to assess evolution of RV systolic function during CRT, covariates associated with its improvement, and its impact on outcome. Methods and results All CRT device implantations (Jan 2009-Dec 2011) in our institution were reviewed. Records of 69 patients (25% female, mean age 62.8 ± 9.2 years, mean left ventricular (LV) ejection fraction 27 ± 8%) were analyzed. Baseline RV fractional area change (FAC) < 35% was present in 37 patients (54%). At one year, 24 of them (65%) improved in RV FAC. LV remodeling and mitral regurgitation were significantly associated with the likelihood of RV FAC improvement (OR 4.80, 95% CI 1.13-20.46, P = 0.034 and OR 0.32, 95% CI 0.12-0.89, P = 0.029, respectively). The composite endpoint of death or heart transplantation occurred in 23 patients (33%) over a mean follow-up of 2.8 ± 1.4 years. RV FAC at one year (HR 0.90, 95% CI 0.86-0.94, P < .001) was, independently of NYHA class and LV remodeling, associated with clinical outcome. Conclusions RV systolic function might improve during CRT. This seems mainly due to changed left-sided hemodynamics and LV remodeling. Good RV systolic function is independently related with better outcome.
- Subjects :
- Echocardiography
Female
Follow-Up Studies
Heart Failure diagnosis
Heart Failure physiopathology
Heart Ventricles diagnostic imaging
Humans
Male
Middle Aged
Prognosis
Retrospective Studies
Stroke Volume
Systole
Treatment Outcome
Cardiac Resynchronization Therapy methods
Heart Failure therapy
Heart Ventricles physiopathology
Ventricular Function, Right physiology
Ventricular Remodeling physiology
Subjects
Details
- Language :
- English
- ISSN :
- 0001-5385
- Volume :
- 72
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Acta cardiologica
- Publication Type :
- Academic Journal
- Accession number :
- 28636525
- Full Text :
- https://doi.org/10.1080/00015385.2017.1305177