Abstract 14768: Echocardiographic Strain Outcomes of Cardiac Resynchronization Therapy in Patients With Chemotherapy Induced Cardiomyopathy

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Fatima M Ezzeddine ◽  
Antoine N Saliba ◽  
Vaibhav Jain ◽  
Hector R Villarraga ◽  
Joerg Herrmann ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Strain Rate ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Control Group ◽  
Resynchronization Therapy ◽  
Control Groups ◽  
Left Ventricular Strain ◽  
The Mean ◽  
And Control

Introduction: Several chemotherapy agents, especially anthracyclines, are associated with the development of non-ischemic cardiomyopathy. When chemotherapy-induced cardiomyopathy (CHIC) is associated with left bundle branch block (QRS >150 ms) and a left ventricular ejection fraction (LVEF) of 35% or lower, cardiac resynchronization therapy (CRT) is often utilized to improve cardiac function and relieve symptoms. Hypothesis: CRT is associated with improvement in left ventricular strain in patients with CHIC. Methods: The study included 22 patients with CHIC and 44 age- and gender-matched controls with other types of NIC who underwent CRT implantation between 2004 and 2017. LVEF, left ventricular global longitudinal strain (GLS), systolic strain rate (SRS), and early diastolic strain rate (SRE) were assessed at baseline and 6-18 months after CRT. CRT response was defined as LVEF improvement by >5% after CRT. Results: CRT responders had a significant improvement in left ventricular GLS as compared to CRT non-responders in the control group, but not in the CHIC group (Table 1). The mean change in LVEF after CRT was similar between the CHIC and control groups (10 ± 10% versus 11 ± 11%, p= 0.67). The mean change in GLS after CRT was also similar between the two groups (-2.15 ± 4.32 versus -3.57 ± 4.02, p= 0.19). The proportion of patients whose LVEF increased by more than 5% was similar between the two groups (59% in the CHIC group versus 68% in the control group, p= 0.46). The mean changes in LV myocardial systolic and early diastolic strain rates were similar between the CHIC and control groups. Mean SRS decreased by 0.13 ± 0.14 in the CHIC group and by 0.34 ± 1.28 in the control group (p=0.45). Mean SRE increased by 0.06 ± 0.18 in the CHIC group and by 0.07 ± 0.22 in the control group (p=0.86). Conclusions: CRT is associated with improvement in left ventricular strain in patients with CHIC. Prospective studies are needed to further evaluate the echocardiographic strain outcomes of CRT in CHIC.

scholarly journals Echocardiographic evaluation of cardiac resynchronization therapy

2006 ◽  
Vol 134 (11-12) ◽  
pp. 488-491 ◽  
Author(s):  
Milan Petrovic ◽  
Goran Milasinovic ◽  
Bosiljka Vujisic-Tesic ◽  
Vera Jelic ◽  
Zarko Calovic ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Diastolic Filling ◽  
Lv Function ◽  
Mitral Insufficiency ◽  
Stroke Index ◽  
Resynchronization Therapy ◽  
Filling Time ◽  
The Mean

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.

Abstract 2285: Acute and Chronic Improvement in Left Ventricular Diastolic Function Following Cardiac Resynchronization Therapy

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Glen Miske ◽  
Masaki Tanabe ◽  
Nini C Thomas ◽  
David Schwartzman ◽  
John Gorcsan
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Diastolic Function ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Control Group ◽  
Resynchronization Therapy ◽  
Beneficial Effects ◽  
Lv Diastolic Function ◽  
Deceleration Time

Background: Cardiac resynchronization therapy (CRT) has been shown to result in improvements in left ventricular (LV) systolic function, but its effects on diastolic function are not well understood. Our aim was to test the hypothesis that CRT acutely improves LV diastolic function and that these benefits are sustained in chronic follow-up. Methods: We studied 40 NYHA Class III–IV heart failure patients (65±10 yrs, ejection fraction 24±7%, QRS duration 166±26 ms, 62% ischemic) at baseline, 24 hours after CRT, and 6±3 mo. after CRT. A control group of 10 normal subjects were also studied. Quantitative pulsed wave and tissue Doppler measures of diastolic function included: mitral inflow peak E and A wave velocity, E deceleration time, mitral annular E′ velocity (septal and lateral sites) and estimation of LV filling pressure by E/E′. Results: All CRT patients had baseline diastolic dysfunction, as expected: Deceleration Time = 163±53 ms, E′ = 3.4±1.6 cm/sec, E/E′ = 40±20, peak E wave = 1.11±0.3 m/sec, peak A wave = 0.5±.3 m/sec, (all p < 0.05 vs. controls). Diastolic function acutely improved following CRT: Deceleration Time = 218±52 ms*, E′= 4.3±1.8 cm/sec*, and E/E′ = 29±19*, peak E wave = 1.01±0.26 m/sec*, peak A wave = 0.7±.34 m/sec* (all p < 0.05 vs. baseline). These beneficial effects of CRT were sustained 6±3 month following CRT (all p < 0.05 vs. baseline). Conclusion: CRT was associated with acute improvements in LV diastolic function. These improvements were sustained through chronic follow-up. These findings extend the understanding of beneficial effects of CRT on LV function.

scholarly journals Redistribution of left ventricular strain by cardiac resynchronization therapy in heart failure patients

2011 ◽  
Vol 13 (2) ◽  
pp. 186-194 ◽  
Author(s):  
Julija Klimusina ◽  
Bart W. De Boeck ◽  
Geert E.H. Leenders ◽  
Francesco F. Faletra ◽  
Frits Prinzen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Left Ventricular Strain ◽  
Heart Failure Patients

scholarly journals Chagas disease is associated with a poor outcome at 1-year follow-up after cardiac resynchronization therapy

2019 ◽  
Vol 65 (11) ◽  
pp. 1391-1396
Author(s):  
Luiz Carlos Santana Passos ◽  
Rodrigo Morel Vieira de Melo ◽  
Yasmin Menezes Lira ◽  
Natalia Ferreira Cardoso de Oliveira ◽  
Thiago Trindade ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Chagas Disease ◽  
Univariate Analysis ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Left Ventricular Ejection ◽  
Resynchronization Therapy ◽  
Ventricular Ejection Fraction ◽  
The Mean

SUMMARY BACKGROUND: Cardiac resynchronization therapy (CRT) is a therapeutic modality for patients with heart failure (HF). The effectiveness of this treatment for event reduction is based on clinical trials where the population of patients with Chagas' disease (DC) is underrepresented. OBJECTIVE: To evaluate the prognosis after CRT of a population in which CD is an endemic cause of HF. METHODS: A retrospective cohort conducted between January 2015 and December 2016 that included patients with HF and left ventricular ejection fraction (LVEF) of less than 35% and undergoing CRT. Clinical and demographic data were collected to search for predictors for the combined outcome of death or hospitalization for HF at one year after CRT implantation. RESULTS: Fifty-four patients were evaluated, and 13 (24.1%) presented CD as the etiology of HF. The mean LVEF was 26.2± 6.1%, and 36 (66.7%) patients presented functional class III or IV HF. After the mean follow-up of 15 (±6,9) months, 17 (32.1%) patients presented the combined outcome. In the univariate analysis, CD was associated with the combined event when compared to other etiologies of HF, 8 (47%) vs. 9 (13,5%), RR: 3,91 CI: 1,46–10,45, p=0,007, as well as lower values of LVEF. In the multivariate analysis, CD and LVEF remained independent risk factors for the combined outcome. CONCLUSION: In a population of HF patients undergoing CRT, CD was independently associated with mortality and hospitalization for HF.

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