Impact of Contractile Reserve on Cardiac Resynchronization Therapy Response
Author Information
Author(s): Marie Moonen, Mario Senechal, Bernard Cosyns, Pierre Melon, Eric Nellessen, Luc Pierard, Patrizio Lancellotti
Primary Institution: Department of Cardiology, CHU Sart Tilman, Liege, Belgium
Hypothesis
The study investigates the impact of myocardial contractile reserve on the acute response to cardiac resynchronization therapy (CRT).
Conclusion
Response to CRT largely depends on the extent of left ventricular dyssynchrony, severity of mitral regurgitation, and presence of contractile reserve.
Supporting Evidence
- Responders showed a greater exercise-induced increase in left ventricular ejection fraction.
- The presence of contractile reserve was directly related to the acute increase in stroke volume.
- Baseline myocardial deformation was greater in responders during exercise than in nonresponders.
Takeaway
This study found that patients with heart failure who have more heart muscle that can contract well are more likely to benefit from a specific heart treatment called CRT.
Methodology
Fifty-one patients with heart failure underwent exercise Doppler echocardiography to assess contractile reserve before CRT implantation.
Limitations
The study population was not completely homogenous, consisting of patients with both ischemic and non-ischemic heart failure.
Participant Demographics
Patients included 34 with ischemic heart disease and 17 with idiopathic dilated cardiomyopathy.
Statistical Information
P-Value
p<0.001
Confidence Interval
95% CI 0.39–0.94
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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