Echocardiographic measures of acute haemodynamic response after cardiac resynchronization therapy predict long-term clinical outcome

Francois B. Tournoux, Chrisfouad Alabiad, Dali Fan, Annabel A. Chen, Miguel Chaput, Edwin Kevin Heist, Theofanie Mela, Moussa Mansour, Vivek Reddy, Jeremy N. Ruskin, Michael H. Picard, Jagmeet P. Singh

Research output: Contribution to journalArticle

50 Scopus citations

Abstract

Aims: Although acute haemodynamic improvement in response to cardiac resynchronization therapy (CRT) is reflective of a favourable cardiac contractile response, there is limited information regarding not only its ability to predict long-term clinical outcome but also cardiac-substrate- specific differences in the prognostic value of this measure. Methods and results: Fifty-three heart failure patients (69 ± 11 years) with low left ventricle ejection fraction (LVEF) (22 ± 6%), wide QRS (169 ± 31 ms), and indications for CRT were included. There were no significant differences in age, New York Heart Association (NYHA) class, medications, QRS width, or LVEF between ischaemic (n = 37) and non-ischaemic (n = 16) groups. Echocardiograms were performed within 24 h of implantation with device OFF and ON. Acute haemodynamic response was measured as LV dP/dt derived from the CW Doppler of mitral regurgitation. Percentage change in dP/dt was used to classify patients: high- (HR: ΔdP/dt > 25%) or poor-responders (PR: ΔdP/dt ≤ 25%). Clinical response to CRT was defined by a combined endpoint of hospitalizations and all-cause mortality at 12 months. HR group had a significantly better outcome compared to the PR group (P-value = 0.004) irrespective of the aetiology of the cardiomyopathy. Conclusion: Echocardiographic assessment of the acute haemodynamic response to CRT predicts long-term clinical outcome in both ischaemic and non-ischaemic cardiomyopathy.

Original languageEnglish (US)
Pages (from-to)1143-1148
Number of pages6
JournalEuropean Heart Journal
Volume28
Issue number9
DOIs
StatePublished - May 2007
Externally publishedYes

Keywords

  • Cardiomyopathy
  • Doppler
  • dP/dt
  • Heart failure
  • Long-term outcome
  • Resynchronization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Echocardiographic measures of acute haemodynamic response after cardiac resynchronization therapy predict long-term clinical outcome'. Together they form a unique fingerprint.

  • Cite this

    Tournoux, F. B., Alabiad, C., Fan, D., Chen, A. A., Chaput, M., Heist, E. K., Mela, T., Mansour, M., Reddy, V., Ruskin, J. N., Picard, M. H., & Singh, J. P. (2007). Echocardiographic measures of acute haemodynamic response after cardiac resynchronization therapy predict long-term clinical outcome. European Heart Journal, 28(9), 1143-1148. https://doi.org/10.1093/eurheartj/ehm050