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- Title
Prognostic role of coronary flow reserve for left ventricular functional improvement after cardiac resynchronization therapy in patients with dilated cardiomyopathy.
- Authors
Djordjevic Dikic, Ana; Nikcevic, Gabrijela; Raspopovic, Srdjan; Jovanovic, Velibor; Tesic, Milorad; Beleslin, Branko; Stepanovic, Jelena; Giga, Vojislav; Milasinovic, Goran
- Abstract
Aims The aim of the study was to assess the value of coronary flow reserve (CFR) for predicting improvement of left ventricular function after cardiac resynchronization therapy (CRT). Methods and results Study population included 40 patients (mean age 58 ± 9 years) with heart failure (ejection fraction 25, 7 ± 5,4%) and QRS duration of 158 ± 22 ms, planned for CRT. Before and after CRT implantation, CFR was measured non-invasively during hyperaemia induced with adenosine. Responders were defined by decrease in end-systolic volume ≥ 15%. Follow-up echocardiography and CFR measurements were obtained after 6 months. At baseline there was no significant difference in left ventricular ejection fraction (LVEF), QRS duration, 6 min walk test distance and coronary flow velocity at rest between responder (n = 26) vs. non-responder group (n = 14, P = ns). Before CRT implantation, responders compared with non-responders, showed a greater increase in coronary flow velocity during hyperaemia, and consequently higher CFR: 2.41 ± 0.60 vs. 1.61 ± 0.45 (P = 0.001). There was significant correlation between CFR before CRT implantation and LVEF after 6 months (r = 0.545, P = 0.001). End-diastolic, end-systolic left ventricular diameter, and CFR before CRT were predictors of LV functional improvement. By multivariate analysis, only CFR before CRT was independent predictor of left ventricular recovery in the follow-up period (P = 0.001). Conclusion Our results demonstrate that preserved CFR in patients with dilated cardiomyopathy is predictive of left ventricular improvement after CRT implantation.
- Subjects
HEART physiology; LEFT heart ventricle; HYPERTENSION; CARDIOVASCULAR disease diagnosis; DILATED cardiomyopathy; BLOOD circulation; BUNDLE-branch block; CARDIAC output; CARDIAC pacing; CARDIOLOGY; CORONARY arteries; DIAGNOSTIC imaging; HEART beat; RESEARCH funding; COMORBIDITY; DATA analysis; PATIENT selection; DESCRIPTIVE statistics; THERAPEUTICS
- Publication
European Heart Journal - Cardiovascular Imaging, 2014, Vol 15, Issue 12, p1344
- ISSN
2047-2404
- Publication type
Article
- DOI
10.1093/ehjci/jeu136