Author + information
- Received September 11, 2001
- Revision received April 17, 2002
- Accepted May 20, 2002
- Published online August 21, 2002.
- Peter Søgaard, MD, DMSc*,* (, )
- Henrik Egeblad, MD, DMSc, FESC*,
- W.Yong Kim, MD, PhD*,
- Henrik K. Jensen, MD, PhD*,
- Anders K. Pedersen, MD, DMSc*,
- Bent Ø. Kristensen, MD, DMSc* and
- Peter T. Mortensen, MD*
- ↵*Reprint requests and correspondence:
Dr. Peter Søgaard, Department of Cardiology, Aarhus University Hospital, DK-8200 Aarhus North, Denmark.
Objectives We sought to evaluate the long-term impact of cardiac resynchronization therapy (CRT) on left ventricular (LV) performance and remodeling using three-dimensional echocardiography and tissue Doppler imaging (TDI).
Background Three-dimensional echocardiography and TDI allow rapid and accurate evaluation of LV volumes and performance.
Methods Twenty-five consecutive patients with severe heart failure and bundle branch block who underwent biventricular pacemaker implantation were included. Before and after implantation of the pacemaker, three-dimensional echocardiography and TDI were performed. These examinations were repeated at outpatient visits every six months.
Results Five patients (20%) died during one-year follow-up. In the remaining 20 patients, significant reductions in LV end-diastolic volume and LV end-systolic volume of 9.6 ± 14% and 16.5 ± 15%, respectively (p < 0.01), could be demonstrated during long-term follow-up. Accordingly, LV ejection fraction increased by 21.7 ± 18% (p < 0.01). According to a newly developed TDI technique—tissue tracking—all regional myocardial segments improved their longitudinal systolic shortening (p < 0.01). The extent of the LV base displaying delayed longitudinal contraction, as detected by TDI before pacemaker implantation, predicted long-term efficacy of CRT. The QRS duration failed to predict resynchronization efficacy.
Conclusions Cardiac resynchronization significantly improved LV function and reversed LV remodeling during long-term follow-up. Patients likely to benefit from CRT can be identified by TDI before implantation of a biventricular pacemaker.
- Received September 11, 2001.
- Revision received April 17, 2002.
- Accepted May 20, 2002.
- American College of Cardiology Foundation