- 作者：Ana Flores-Marí ; n ; Fernando Cabrera-Bueno ; fjcabrera@secardiologia.es ; Javier Alzueta ; Marí ; a J. Molina-Mora ; Julia Ferná ; ndez-Pastor ; José ; L. Peñ ; a-Herná ; ndez ; Alberto Barrera ; Eduardo De Teresa
- 关键词：Resincronizació ; n cardí ; aca ; Remodelado inverso ; Insuficiencia cardí ; aca
- 刊名：Cardiocore
- 出版年：2010
- 期刊代码：pca84_1889898X
- 类别：med
- 出版时间：January-March 2010
- 卷：45
- 期：1
- 页码：5-10
- 文件大小：169 K
Objectives
We aimed to study if the presence of reverse remodelling during follow-up in patients successfully implanted with a cardiac resynchronization therapy device is associated with a better clinical evolution.
Methods
This retrospective study included 86 patients who fitted current indications for cardiac resynchronization therapy. A complete echocardiography study was performed at baseline and 6 months after the device implantation. We studied the possible relationship between the presence of significant reverse remodelling (defined as the reduction of left ventricle end-systolic volume 鈮?0%) and the occurrence of cardiac adverse events during follow-up (death, transplantation and admission due to heart failure).
Results
Over a mean follow-up of 14卤10 months, we documented cardiac adverse events in 19 patients (7 deaths and 12 heart failure admissions). Patients showing a worse clinical outcome had larger left ventricular end-diastolic (259卤62 vs 205卤87 ml; p=0.024) and end-systolic volumes (204卤57 vs 165卤72 mL; p=0.034) in baseline echocardiography. They also showed a wider stimulated QRS complex (136卤15 vs 123卤16 ms; p=0.02) and a smaller reduction of the end-systolic left ventricular volume (8卤19%vs 32卤26%; p=0.008) at 6 months. We identified that the presence of significant reverse remodelling was as an independent predictor of a better clinical outcome (OR=5.4; 95%CI=1.69 鈥?#xA0;17.6).
Conclusion
The presence of reverse remodelling is associated with decreased cardiac adverse events in middle-long term in patients undergoing Cardiac Resynchronization Therapy.