Abstract:
BACKGROUND:Patients with heart failure frequently exhibit intraventricular conduction delays, which contribute to asynchronous contraction patterns and impaired hemodynamic performance. Cardiac resynchronization therapy (CRT) with biventricular (BV) and left ventricular (LV) pacing has been shown to improve both hemodynamic and clinical performance. This study investigated the effects of CRT on LV Doppler indices in these patients. METHODS AND RESULTS:Thirty-two patients with advanced heart failure (New York Heart Association class > or =III, QRS >120 milliseconds, PR interval >150 milliseconds) were studied 4 weeks after implantation of a CRT system. Doppler echocardiography was conducted in 3 separate CRT modes, right ventricular, LV, and BV stimulation at 3 different atrioventricular delays. CRT resulted in significant improvement of Doppler parameters such as filling time (FT, 313 +/- 111 milliseconds at baseline --> 363 +/- 154 milliseconds [BV], P <.05), aortic velocity time integral (AO(VTI) 23.2 +/- 7.4 cm at baseline --> 26.8 +/- 8.8 cm [LV], P <.05), and the myocardial performance index (MPI, 1.21 +/- 0.51 at baseline --> 0.85 +/- 0.34 [BV], P <.05). The most improvement was observed with LV and BV stimulation at short and intermediate atrioventricular delays (80-120 milliseconds), independent of ischemic or idiopathic origin. CONCLUSIONS:CRT improves hemodynamic performance in patients with heart failure with intraventricular conduction delays. Doppler echocardiography allows noninvasive evaluation of acute CRT effects in patients with heart failure. In particular, FT, AO(VTI), and MPI are useful parameters for noninvasive follow-up and optimization of pacing parameters.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Breithardt OA,Stellbrink C,Franke A,Balta O,Diem BH,Bakker P,Sack S,Auricchio A,Pochet T,Salo R,Pacing Therapies for Congestive Heart Failure Study Group.,Guidant Congestive Heart Failure Research Group.doi
10.1067/mhj.2002.119616subject
Has Abstractpub_date
2002-01-01 00:00:00pages
34-44issue
1eissn
0002-8703issn
1097-6744pii
S0002870302679864journal_volume
143pub_type
杂志文章abstract::In a double-blind, randomized crossover study of 12 patients suffering from chronic bronchitis, the comparative influence of equipotent doses of pindolol (5 mg) and metoprolol (100 mg) on the bronchodilatory potential of inhaled fenoterol (0.4 mg), a beta 2-agonist, was investigated by means of body plethysmography. N...
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pub_type: 临床试验,杂志文章,随机对照试验
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