Evaluation of echocardiographic optimization of cardiac resynchronization therapy using VTI parameters
نویسندگان
چکیده
Contact address: Zsolt Gyalai, MD Department of Cardiology, Mureş County Clinical Hospital Gheorghe Marinescu Street, no. 1, 540103, Târgu Mureş, Romania E-mail address: [email protected] 1 Department of Cardiology, Mureş County Clinical Hospital, Târgu Mureş, Romania 2 Department of Cardiology, Emergency Institute of Cardiovascular Diseases and Transplantation, Târgu Mureş, Romania 3 University of Medicine and Pharmacy Târgu Mureş, Romania Abstract: Cardiac resynchronization therapy (CRT) can improve left ventricular function and symptoms of heart failure by restoring synchronous left ventricular (LV) contractions. Although this improvement is achieved in the majority of patients, some 30% of those who underwent CRT remain non-responders. A number of methods have been tested to improve the rate of responders and convert non-responders into responders, among which different echocardiographic methods. The aim of this study was to establish whether echocardiographic parameters of mitral and aortic velocity time integral (VTI) can help to optimize CRT settings. 27 patients with CRT have been included in the study; demographic, clinical (blood pressure, laboratory parameters, etiology of heart failure, comorbidities, ECG), therapeutic and echocardiographic (standard measurements, LVDFT/RR, IMD, SPWMD, aortic and mitral-VTI, LVEF, dp/dt, GMI) parameters were assessed. Patients underwent echocardiography to determine dyssynchrony parameters with actual CRT, without CRT and with optimized CRT settings, which was carried out using the aortic and mitral-VTI. Our results indicate that echocardiographic optimization using VTI parameters did not improve mechanical dyssynchrony and acute left ventricular function parameters in patients with CRT and should be considered only in selected cases of CRT non-responders, associated with other optimization methods.
منابع مشابه
Echocardiography in cardiac resynchronization therapy.
Cardiac resynchronization therapy has been an effective option in patients with advanced heart failure. However, 20 to 30% of the patients do not benefit from this therapy. Clinical, electrocardiographic and echocardiographic criteria have been studied in an attempt to select patients who will benefit from a cardiac resynchronization therapy, and the echocardiogram is important both in the sele...
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