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Evaluation of left ventricular function and mitral regurgitation during left ventricular-based pacing in patients with heart failure.

Abstract：

BACKGROUND:Beneficial effects of left ventricular (LV)-based pacing on acute hemodynamic parameters were reported in several series, but only a few studies examined the long-term effects of this new pacing procedure. AIMS:To assess long-term effects of permanent LV-based pacing on LV function and mitral regurgitation (MR) in patients with refractory congestive heart failure (CHF). METHODS:A prospective evaluation of LV function and MR was performed in 23 patients with severe but stable CHF and left bundle branch block (mean QRS: 186+/-31 ms) by radionuclide and echocardiographic techniques at baseline and 6 months after implantation of a permanent LV-based (LV alone: 13 patients; biventricular: 10 patients) pacemaker programmed either in a DDD mode (sinus rhythm; n=14) or in a VVIR mode (atrial fibrillation; n=9). RESULTS:Compared to baseline, the 6 months follow-up visit demonstrated a significant increase in radionuclide derived LV ejection fraction from 23.3+/-7 to 26.2+/-7% (P<0.01) and in echocardiographic LV fractional shortening from 13+/-4 to 16+/-6% (P<0.05), without any change in cardiac index, a significant decrease in LV end-diastolic diameter (from 73.2+/-6 to 71.2+/-7 mm; P<0.05), end-systolic diameter (from 63.6+/-6 to 60.2+/-8 mm; P<0.05) and color Doppler MR jet area (from 11.5+/-6 to 6.6+/-4 cm(1); P<0.001). A comparison of patients with LV pacing alone and patients with biventricular pacing showed similar beneficial effects of pacing on MR severity in the two subgroups and a non-significant trend for a better improvement of LV function during biventricular pacing. CONCLUSION:Thus, in patients with severe CHF and left bundle branch block, permanent LV-based pacing may significantly improve LV systolic function and decrease MR.

journal_name

Eur J Heart Fail

journal_title

European journal of heart failure

authors

Etienne Y,Mansourati J,Touiza A,Gilard M,Bertault-Valls V,Guillo P,Boschat J,Blanc JJ

doi

10.1016/s1388-9842(01)00145-3

keywords:

subject

Has Abstract

pub_date

2001-08-01 00:00:00

pages

441-7

issue

eissn

1388-9842

issn

1879-0844

pii

S1388-9842(01)00145-3

journal_volume

pub_type

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Evaluation of left ventricular function and mitral regurgitation during left ventricular-based pacing in patients with heart failure.