Influence of aetiology on long-term effects of resynchronization on cardiac structure and function in patients treated with ß-blockers.
J Cardiovasc Med (Hagerstown)
; 12(4): 227-33, 2011 Apr.
Article
em En
| MEDLINE
| ID: mdl-21252694
ABSTRACT
OBJECTIVES:
Cardiac resynchronization therapy (CRT) elicits more beneficial effects on left-ventricular (LV) structure and function, and long-term clinical outcomes in nonischemic heart failure patients. Rates of ß-blocker use in recent heart failure trials are higher than in CRT trials and this may influence the response to CRT. This study examined the long-term effects of CRT on LV structure and function in New York Heart Association class III-IV ß-blocker-treated patients.METHODS:
One hundred and four (41 ischemic and 63 nonischemic) CRT patients, who were receiving ß-blockers before and throughout 12 months following device implantation, were retrospectively selected. Variations in echocardiographic parameters recorded before, and 6 and 12 months after CRT were analyzed.RESULTS:
Selected patients were all stable on ß-blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (97%) and diuretics (97%) before implantation. CRT was associated with significant improvements in LV morphological and systo-diastolic functional parameters at 6 months, with further improvements between 6 and 12 months seen in nonischemic patients only. Accordingly, rates of echocardiographic response to CRT were similar at 6 months but significantly higher in nonischemic patients after 1 year. The degree of reduction in LV diameters and volumes, and of increase in ejection fraction, was significantly larger in nonischemic patients at both 6 and 12 months. In addition, a significant reduction in LV mass and severity of mitral regurgitation was more evident in nonischemic patients both 6 and 12 months following CRT.CONCLUSIONS:
Ischemic aetiology of heart failure is associated with less favorable long-term effects of CRT on LV structure and function despite the systematic use of ß-blockers.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Função Ventricular Esquerda
/
Isquemia Miocárdica
/
Antagonistas Adrenérgicos beta
/
Remodelação Ventricular
/
Terapia de Ressincronização Cardíaca
/
Insuficiência Cardíaca
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article