Echocardiographic evaluation of cardiac resynchronization therapy

Abstract

Introduction: Cardiac resynchronization therapy (CRT) is relatively new tool in treatment of chronic heart failure (HF), especially in dilated cardiomyopathy (DCM) with the left bundle branch block (LBBB). Objective: The Objective of our study was to assess the success of CRT in treatment of severe HF and the role of echocardiography in the evaluation of Results of such therapy. Method: The group consisted of 19 patients, 13 males and 6 females, mean age 58.0±8.22 years (47-65 years) with CRT applied for DCM, severe HF (NYHA III-IV), LBBB and ejection fraction (EF) <35%. The mean follow up was 17 months (6.5-30). Standard color Doppler echocardiography examination was performed in all patients before and after CRT. The parameters of systolic and diastolic left ventricular function, mitral insufficiency and the right ventricular pressure were evaluated. Results: Following the CRT, statistically significant improvement of the end-systolic LV dimension, cardiac output, cardiac index, myocardial performance index (p<0.01) and stroke index (p<0.05) was recorded. The mean value of EFLV was increased by 10% and LV fractional shortening improved by 6% in 10/16 (62%) patients. CRT resulted in decreased MR (p<0.01), prolonged LV diastolic filling time (p<0.02) and reduced RV pressure (p<0.05). Interventricular mechanical delay was shortened by 28% (18 msec) Conclusion: CRT has an important role in improvement of LV function and correction of ventricular asynchrony. The echocardiography is a useful tool for evaluation of HF treatment with CRT.

Keywords

• echocardiography
• cardiac resynchronization therapy
• heart failure