Abstract
Aims: Cardiac resynchronization therapy (CRT) can stop the vicious cycle resulting from dyssynchrony and generates left ventricular (LV) reverse remodelling. Our objective was to assess the time course and the relationship between improvement in LV dyssynchrony and reverse remodelling after CRT. Methods and results: Sixty-four consecutive patients were evaluated before, immediately after, and 3- and 6 months after CRT. We measured LV volumes, ejection fraction (EF), and sphericity index, and dyssynchrony was assessed using speckletracking radial strain. Response was defined as a >15% decrease in end-systolic volume (ESV) 6 months after CRT, and event-free survival was followed for 24 months. Responders and non-responders had similar baseline LV volumes and EF. During the first and the following 3 months after CRT, LV volumes gradually decreased (enddiastolic volume: 195±73 to 164+60* to 129±51 mL†, ESV: 141±70 to 110±47* to 82±40 mL†), and sphericity index and EF progressively increased (sphericity index: 1.52±0.20 to 1.75±0.31* to 1.94±0.34†, EF: 28±7 to 34±7* to 38±8%†, *†P < 0.001) in responders. No such changes were observed in non-responders. Furthermore, dyssynchrony diminished progressively during the first and the following 3 months after CRT and patients with progressive resynchronization experienced fewer major cardiovascular events than those without (P < 0.001). Conclusion: CRT can stop the vicious cycle of remodelling and dyssynchrony, and actually, turn it into the virtuous cycle of reverse remodelling and further resynchronization. All rights reserved.
| Original language | English |
|---|---|
| Pages (from-to) | 782-789 |
| Number of pages | 8 |
| Journal | European Journal of Echocardiography |
| Volume | 12 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - 2011 Oct |
| Externally published | Yes |
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Keywords
- Cardiac resynchronization therapy
- Dyssynchrony
- Reverse remodelling Introdu
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Radiology Nuclear Medicine and imaging
Cite this
Reverse remodelling induces progressive ventricular resynchronization after cardiac resynchronization therapy 'from vicious to virtuous cycle'. / Matsumoto, Kensuke; Tanaka, Hidekazu; Okajima, Katsunori; Hayashi, Takatoshi; Kajiya, Teishi; Sugiyama, Daisuke; Kawai, Hiroya; Hirata, Ken Ichi.
In: European Journal of Echocardiography, Vol. 12, No. 10, 10.2011, p. 782-789.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Reverse remodelling induces progressive ventricular resynchronization after cardiac resynchronization therapy 'from vicious to virtuous cycle'
AU - Matsumoto, Kensuke
AU - Tanaka, Hidekazu
AU - Okajima, Katsunori
AU - Hayashi, Takatoshi
AU - Kajiya, Teishi
AU - Sugiyama, Daisuke
AU - Kawai, Hiroya
AU - Hirata, Ken Ichi
PY - 2011/10
Y1 - 2011/10
N2 - Aims: Cardiac resynchronization therapy (CRT) can stop the vicious cycle resulting from dyssynchrony and generates left ventricular (LV) reverse remodelling. Our objective was to assess the time course and the relationship between improvement in LV dyssynchrony and reverse remodelling after CRT. Methods and results: Sixty-four consecutive patients were evaluated before, immediately after, and 3- and 6 months after CRT. We measured LV volumes, ejection fraction (EF), and sphericity index, and dyssynchrony was assessed using speckletracking radial strain. Response was defined as a >15% decrease in end-systolic volume (ESV) 6 months after CRT, and event-free survival was followed for 24 months. Responders and non-responders had similar baseline LV volumes and EF. During the first and the following 3 months after CRT, LV volumes gradually decreased (enddiastolic volume: 195±73 to 164+60* to 129±51 mL†, ESV: 141±70 to 110±47* to 82±40 mL†), and sphericity index and EF progressively increased (sphericity index: 1.52±0.20 to 1.75±0.31* to 1.94±0.34†, EF: 28±7 to 34±7* to 38±8%†, *†P < 0.001) in responders. No such changes were observed in non-responders. Furthermore, dyssynchrony diminished progressively during the first and the following 3 months after CRT and patients with progressive resynchronization experienced fewer major cardiovascular events than those without (P < 0.001). Conclusion: CRT can stop the vicious cycle of remodelling and dyssynchrony, and actually, turn it into the virtuous cycle of reverse remodelling and further resynchronization. All rights reserved.
AB - Aims: Cardiac resynchronization therapy (CRT) can stop the vicious cycle resulting from dyssynchrony and generates left ventricular (LV) reverse remodelling. Our objective was to assess the time course and the relationship between improvement in LV dyssynchrony and reverse remodelling after CRT. Methods and results: Sixty-four consecutive patients were evaluated before, immediately after, and 3- and 6 months after CRT. We measured LV volumes, ejection fraction (EF), and sphericity index, and dyssynchrony was assessed using speckletracking radial strain. Response was defined as a >15% decrease in end-systolic volume (ESV) 6 months after CRT, and event-free survival was followed for 24 months. Responders and non-responders had similar baseline LV volumes and EF. During the first and the following 3 months after CRT, LV volumes gradually decreased (enddiastolic volume: 195±73 to 164+60* to 129±51 mL†, ESV: 141±70 to 110±47* to 82±40 mL†), and sphericity index and EF progressively increased (sphericity index: 1.52±0.20 to 1.75±0.31* to 1.94±0.34†, EF: 28±7 to 34±7* to 38±8%†, *†P < 0.001) in responders. No such changes were observed in non-responders. Furthermore, dyssynchrony diminished progressively during the first and the following 3 months after CRT and patients with progressive resynchronization experienced fewer major cardiovascular events than those without (P < 0.001). Conclusion: CRT can stop the vicious cycle of remodelling and dyssynchrony, and actually, turn it into the virtuous cycle of reverse remodelling and further resynchronization. All rights reserved.
KW - Cardiac resynchronization therapy
KW - Dyssynchrony
KW - Reverse remodelling Introdu
UR - http://www.scopus.com/inward/record.url?scp=84856378204&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84856378204&partnerID=8YFLogxK
U2 - 10.1093/ejechocard/jer143
DO - 10.1093/ejechocard/jer143
M3 - Article
C2 - 21865225
AN - SCOPUS:84856378204
VL - 12
SP - 782
EP - 789
JO - European Heart Journal Cardiovascular Imaging
JF - European Heart Journal Cardiovascular Imaging
SN - 2047-2404
IS - 10
ER -