Effect of biventricular pacing on diastolic dyssynchrony

Shanks, Miriam, Bertini, Matteo, Delgado, Victoria, Ng, Arnold C. T., Nucifora, Gaetano, van Bommel, Rutger J., Borleffs, C. Jan Willem, Holman, Eduard R., van de Veire, Nico R. L., Schalij, Martin J. and Bax, Jeroen J. (2010) Effect of biventricular pacing on diastolic dyssynchrony. Journal of the American College of Cardiology, 56 19: 1567-1575. doi:10.1016/j.jacc.2010.01.077


Author Shanks, Miriam
Bertini, Matteo
Delgado, Victoria
Ng, Arnold C. T.
Nucifora, Gaetano
van Bommel, Rutger J.
Borleffs, C. Jan Willem
Holman, Eduard R.
van de Veire, Nico R. L.
Schalij, Martin J.
Bax, Jeroen J.
Title Effect of biventricular pacing on diastolic dyssynchrony
Journal name Journal of the American College of Cardiology   Check publisher's open access policy
ISSN 0735-1097
1558-3597
Publication date 2010-11
Sub-type Article (original research)
DOI 10.1016/j.jacc.2010.01.077
Volume 56
Issue 19
Start page 1567
End page 1575
Total pages 9
Place of publication San Diego, CA, United States
Publisher Elsevier
Language eng
Formatted abstract
Objectives: This study sought to examine the changes in diastolic dyssynchrony with cardiac resynchronization therapy (CRT).

Background:
Little is known about the effect of CRT on diastolic dyssynchrony.

Methods: Consecutive heart failure patients (n = 266, age 65.7 ± 10.0 years) underwent color-coded tissue Doppler imaging at baseline, 48 h, and 6 months after CRT. Systolic and diastolic dyssynchrony were defined as maximal time delay in peak systolic and early diastolic velocities, respectively, in 4 basal LV segments. CRT responders were defined as those with <15% decrease in LV end-systolic volume at 6 months.

Results: Baseline LVEF was 25.2 ± 8.1%; 63.5% patients were CRT responders. Baseline incidence of systolic and diastolic dyssynchrony, and a combination of both was 46.2%, 51.9%, and 28.6%, respectively. Compared to nonresponders, responders had longer baseline systolic (79.2 ± 43.4 ms vs. 45.4 ± 30.4 ms; p < 0.001) and diastolic (78.5 ± 52.0 ms vs. 50.1 ± 38.2 ms; p < 0.001) delays. In follow-up, systolic delays (45.4 ± 31.6 ms at 48 h; 38.9 ± 26.2 ms at 6 months; p < 0.001) and diastolic delays (49.4 ± 36.3 ms at 48 h; 37.7 ± 26.0 ms at 6 months; p < 0.001) improved only in responders.

Conclusions:
At baseline: 1) diastolic dyssynchrony was more common than systolic dyssynchrony in HF patients; 2) nonresponders had less baseline diastolic dyssynchrony compared to responders. After CRT: 1) diastolic dyssynchrony improved only in responders. Further insight into the pathophysiology of diastolic dyssynchrony and its changes with CRT may provide incremental information on patient-specific treatments.
Keyword Cardiac resynchronization therapy
Diastole
Dyssynchrony
Echocardiography
Heart failure
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: School of Medicine Publications
Centre for Advanced Imaging Publications
 
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Created: Mon, 15 Apr 2013, 00:03:12 EST by Dr Chin Tse Arnold Ng on behalf of Examinations