Left ventricle and mitral valve reverse remodeling in response to cardiac resynchronization therapy in nonischemic cardiomyopathy.


Journal

Echocardiography (Mount Kisco, N.Y.)
ISSN: 1540-8175
Titre abrégé: Echocardiography
Pays: United States
ID NLM: 8511187

Informations de publication

Date de publication:
10 2020
Historique:
received: 24 05 2020
revised: 23 07 2020
accepted: 12 08 2020
pubmed: 12 9 2020
medline: 24 6 2021
entrez: 11 9 2020
Statut: ppublish

Résumé

Cardiac resynchronization therapy (CRT) improves left heart geometry and function in nonischemic cardiomyopathy (NICMP). We aimed to detail the effects of CRT on left ventricular (LV) and mitral valve (MV) remodeling using 2-dimensional transthoracic echocardiography. Forty-five consecutive patients with NICMP who underwent CRT implantation between 2009 and 2012, and had pre-CRT and follow-up echocardiograms available, were included. Paired t test, linear and logistic regression, and Kaplan-Meier survival analyses were used for statistical assessment. The mean age and QRS duration were 60 years and 157 ms, respectively, and 13 (28.9%) were female. At a mean follow-up of 3 years, there were 22 (48.9%) "CRT responders" (≥15% reduction in LV end-systolic volume index [LVESVi]). Significant improvements were observed in LV ejection fraction (26.3% vs 34.3%) and LVESVi (87.7 vs 71.1 mL/m Cardiac resynchronization therapy improves LV and MV geometry and function in half of patients with NICMP, which is paralleled by decreased mitral regurgitation severity. The extent of pre-CRT LV remodeling and MV tethering are associated with CRT response.

Sections du résumé

BACKGROUND
Cardiac resynchronization therapy (CRT) improves left heart geometry and function in nonischemic cardiomyopathy (NICMP). We aimed to detail the effects of CRT on left ventricular (LV) and mitral valve (MV) remodeling using 2-dimensional transthoracic echocardiography.
METHODS
Forty-five consecutive patients with NICMP who underwent CRT implantation between 2009 and 2012, and had pre-CRT and follow-up echocardiograms available, were included. Paired t test, linear and logistic regression, and Kaplan-Meier survival analyses were used for statistical assessment.
RESULTS
The mean age and QRS duration were 60 years and 157 ms, respectively, and 13 (28.9%) were female. At a mean follow-up of 3 years, there were 22 (48.9%) "CRT responders" (≥15% reduction in LV end-systolic volume index [LVESVi]). Significant improvements were observed in LV ejection fraction (26.3% vs 34.3%) and LVESVi (87.7 vs 71.1 mL/m
CONCLUSIONS
Cardiac resynchronization therapy improves LV and MV geometry and function in half of patients with NICMP, which is paralleled by decreased mitral regurgitation severity. The extent of pre-CRT LV remodeling and MV tethering are associated with CRT response.

Identifiants

pubmed: 32914427
doi: 10.1111/echo.14844
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1557-1565

Informations de copyright

© 2020 Wiley Periodicals LLC.

Références

Dec GW, Fuster V. Idiopathic dilated cardiomyopathy. N Engl J Med. 1994;331:1564-1575.
Roger VL. Epidemiology of heart failure. Circ Res. 2013;113:646-659.
Asgar AW, Mack MJ, Stone GW. Secondary mitral regurgitation in heart failure: pathophysiology, prognosis, and therapeutic considerations. J Am Coll Cardiol. 2015;65:1231-1248.
Devereux RB, Roman MJ, Paranicas M, et al. A population-based assessment of left ventricular systolic dysfunction in middle-aged and older adults: the strong heart study. Am Heart J. 2001;141:439-446.
Jackson SL, Tong X, King RJ, Loustalot F, Hong Y, Ritchey MD. National burden of heart failure events in the United States, 2006 to 2014. Circ Heart Fail. 2018;11:e004873.
Bristow MR, Saxon LA, Boehmer J, et al. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med. 2004;350:2140-2150.
Cleland JG, Daubert JC, Erdmann E, et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med. 2005;352:1539-1549.
Moss AJ, Hall WJ, Cannom DS, et al. Cardiac resynchronization therapy for the prevention of heart failure events. N Engl J Med. 2009;361:1329-1338.
Tang AS, Wells GA, Talajic M, et al. Cardiac-resynchronization therapy for mild-to-moderate heart failure. N Engl J Med. 2010;363:2385-2395.
Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;62:e147-e239.
Felker GM, Shaw LK, O'Connor CM. A standardized definition of ischemic cardiomyopathy for use in clinical research. J Am Coll Cardiol. 2002;39:210-218.
Godley RW, Wann LS, Rogers EW, Feigenbaum H, Weyman AE. Incomplete mitral leaflet closure in patients with papillary muscle dysfunction. Circulation. 1981;63:565-571.
Zoghbi WA, Adams D, Bonow RO, et al. Recommendations for noninvasive evaluation of native valvular regurgitation: a report from the American Society of Echocardiography developed in collaboration with the Society for Cardiovascular Magnetic Resonance. J Am Soc Echocardiogr. 2017;30:303-371.
Lang RM, Badano LP, Mor-Avi V, et al Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28:1-39.
Nishimura RA, Otto CM, Bonow RO, et al 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2017;70:252-289.
Nordblom P, Bech-Hanssen O. Reference values describing the normal mitral valve and the position of the papillary muscles. Echocardiography. 2007;24:665-672.
Garbi M, Monaghan MJ. Quantitative mitral valve anatomy and pathology. Echo Res Pract. 2015;2:R63-R72.
Van Mieghem NM, Piazza N, Anderson RH, et al. Anatomy of the mitral valvular complex and its implications for transcatheter interventions for mitral regurgitation. J Am Coll Cardiol. 2010;56:617-626.
Weyman AE. “Normal cross-sectional echocardiographic measurements”. Principle and Practice of Echocardiography. Malvern: Lea & Febiger, 1994:1289-1298. Print.
Upadhyay GA, Chatterjee NA, Kandala J, et al. Assessing mitral regurgitation in the prediction of clinical outcome after cardiac resynchronization therapy. Heart Rhythm. 2015;12:1201-1208.
Ng CY, Heist EK. Cardiac resynchronization therapy: maximizing the response to biventricular pacing. Cardiol Rev. 2017;25:6-11.
Saraon T, Katz SD. Reverse remodeling in systolic heart failure. Cardiol Rev. 2015;23:173-181.
Sutton MG, Plappert T, Hilpisch KE, et al. Sustained reverse left ventricular structural remodeling with cardiac resynchronization at one year is a function of etiology: quantitative Doppler echocardiographic evidence from the Multicenter InSync Randomized Clinical Evaluation (MIRACLE). Circulation. 2006;113:266-272.
Karaca O, Avci A, Guler GB, et al. Tenting area reflects disease severity and prognosis in patients with non-ischaemic dilated cardiomyopathy and functional mitral regurgitation. Eur J Heart Fail. 2011;13:284-291.
Watanabe N, Ogasawara Y, Yamaura Y, et al. Geometric differences of the mitral valve tenting between anterior and inferior myocardial infarction with significant ischemic mitral regurgitation: quantitation by novel software system with transthoracic real-time three-dimensional echocardiography. J Am Soc Echocardiogr. 2006;19:71-75.
Mihos CG, Capoulade R, Yucel E, et al. Mitral valve and subvalvular repair for secondary mitral regurgitation: rationale and clinical outcomes of the papillary muscle sling. Cardiol Rev. 2018;26:22-28.
Gogoladze G, Dellis SL, Donnino R, et al. Analysis of the mitral coaptation zone in normal and functional regurgitant valves. Ann Thorac Surg. 2010;89:1158-1161.
Zeng X, Nunes MC, Dent J, et al. Asymmetric versus symmetric tethering patterns in ischemic mitral regurgitation: geometric differences from three-dimensional transesophageal echocardiography. J Am Soc Echocardiogr. 2014;27:367-375.
Jastrzebski M, Baranchuk A, Fijorek K, et al. Cardiac resynchronization therapy-induced acute shortening of QRS duration predicts long-term mortality only in patients with left bundle branch block. Europace. 2019;21:281-289.
Appert L, Menet A, Altes A, et al. Clinical significance of electromechanical dyssynchrony and QRS narrowing in patients with heart failure receiving cardiac resynchronization therapy. Can J Cardiol. 2019;35:27-34.
Aalen JM, Remme EW, Larsen CK, et al. Mechanism of abnormal septal motion in left bundle branch block: role of left ventricular wall interactions and myocardial scar. JACC Cardiovasc Imaging. 2019;12:2402-2413.
Gorcsan J 3rd, Lumens J. Rocking and flashing with RV pacing: Implications for resynchronization therapy. JACC Cardiovasc Imaging. 2017;10:1100-1102.
Underwood SR, Walton S, Laming PJ, Ell PJ, Emanuel RW, Swanton RH. Patterns of ventricular contraction in patients with conduction abnormality studied by radionuclide angiocardiography. Br Heart J. 1984;51:568-574.
Vittinghoff E, McCulloch CE. Relaxing the rule of ten events per variable in logistic and Cox regression. Am J Epidemiol. 2007;165:710-718.

Auteurs

Christos G Mihos (CG)

Echocardiography Laboratory, Columbia University Division of Cardiology, Mount Sinai Heart Institute, Miami Beach, Florida, USA.
Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Evin Yucel (E)

Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Gaurav A Upadhyay (GA)

The University of Chicago Medicine, Chicago, Illinois, USA.

Mary P Orencole (MP)

Cardiac Arrhythmia Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Jagmeet P Singh (JP)

Cardiac Arrhythmia Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Michael H Picard (MH)

Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH