Left ventricular response after cardiac resynchronization therapy is related to early left atrial volume reduction
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Background/Aims: The current study aimed to elucidate a time-course change in left atrial volume after cardiac resynchronization therapy (CRT) and to verify factors associated with left atrial volume reduction (LAVR) and its prognostic implications. Methods: The records of 97 patients were retrospectively reviewed after CRT. Echocardiographic data were analyzed at baseline before CRT, at early follow-up (FU) (≤ 1 year, median 6 months), and at late FU (median 30 months). Left ventricular volume response (LVVR) was defined as 15% reduction in left ventricular (LV) end-systolic volume (ESV). LAVR was classified into two groups by the median value at early FU: LAVR (≥ 7.5%) and no LAVR (< 7.5%). Results: LV ESV index continuously decreased from baseline to early FU and from early FU to late FU (106.1 ± 47.4 mL/m2 vs. 87.6 ± 51.6 mL/m2 vs. 72.5 ± 57.1 mL/m2). LA volume index decreased from baseline to early FU, but there were no reductions thereafter (51.8 ± 21.9 mL/m2 vs. 45.1 ± 19.6 mL/m2 vs. 44.9 ± 23.0 mL/m2). The only echocardiographic factor associated with LAVR was change in E velocity (odds ratio [OR], 1.04; p = 0.002). Early LAVR (OR, 10.05; p = 0.002) was an independent predictor for late LVVR. Conclusions: LAVR was related to reduction in E velocity, suggesting its relation with optimization of LV filling pressure. Early LAVR was a predictor for LVVR to CRT in long-term FU.
Abstract
Background/Aims: The current study aimed to elucidate a time-course change in left atrial volume after cardiac resynchronization therapy (CRT) and to verify factors associated with left atrial volume reduction (LAVR) and its prognostic implications. Methods: The records of 97 patients were retrospectively reviewed after CRT. Echocardiographic data were analyzed at baseline before CRT, at early follow-up (FU) (≤ 1 year, median 6 months), and at late FU (median 30 months). Left ventricular volume response (LVVR) was defined as 15% reduction in left ventricular (LV) end-systolic volume (ESV). LAVR was classified into two groups by the median value at early FU: LAVR (≥ 7.5%) and no LAVR (< 7.5%). Results: LV ESV index continuously decreased from baseline to early FU and from early FU to late FU (106.1 ± 47.4 mL/m2 vs. 87.6 ± 51.6 mL/m2 vs. 72.5 ± 57.1 mL/m2). LA volume index decreased from baseline to early FU, but there were no reductions thereafter (51.8 ± 21.9 mL/m2 vs. 45.1 ± 19.6 mL/m2 vs. 44.9 ± 23.0 mL/m2). The only echocardiographic factor associated with LAVR was change in E velocity (odds ratio [OR], 1.04; p = 0.002). Early LAVR (OR, 10.05; p = 0.002) was an independent predictor for late LVVR. Conclusions: LAVR was related to reduction in E velocity, suggesting its relation with optimization of LV filling pressure. Early LAVR was a predictor for LVVR to CRT in long-term FU.
참고문헌 (29)
- Yancy CW, "2013 ACCF", AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation, J Am Coll Cardiol, pp.2013, 62[DOI]
- Solomon SD, "Effect of cardiac resynchronization therapy on reverse remodeling and relation to outcome : multicenter automatic defibrillator implantation trial : cardiac resynchronization therapy", Circulation, 122, pp.985~992 (2010)
- Kuperstein R, "Left atrial volume and the benefit of cardiac resynchronization therapy in the MADIT-CRT trial", Circ Heart Fail, 7, pp.154~160 (2014)
- Brenyo A, "Cardiac resynchronization therapy reduces left atrial volume and the risk of atrial tachyarrhythmias in MADIT-CRT(Multicenter Automatic Defibrillator Implantation Trial with Cardiac Resynchronization Therapy)", J Am Coll Cardiol, 58, pp.1682~1689 (2011)
- Mathias A, "Clinical implications of complete left-sided reverse remodeling with cardiac resynchronization therapy : a MADIT-CRT Substudy", J Am Coll Cardiol, 68, pp.1268~1276 (2016)
- Ghio S, "Long-term left ventricular reverse remodelling with cardiac resynchronization therapy : results from the CARE-HF trial", Eur J Heart Fail, 11, pp.480~488 (2009)
- Tsang TS, "Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden", Am J Cardiol, 90, pp.1284~1289 (2002)
- Lang RM, "Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology", J Am Soc Echocardiogr, 18, pp.1440~1463 (2005)
- Nagueh SF, "Recommendations for the evaluation of left ventricular diastolic function by echocardiography", J Am Soc Echocardiogr, 22, pp.107~133 (2009)
- Rudski LG, "Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography", J Am Soc Echocardiogr, 23, pp.685~713 (2010)
- Zoghbi WA, "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, 30, pp.303~371 (2017)
- Bax JJ, "Cardiac resynchronization therapy : Part 2. Issues during and after device implantation and unresolved questions", J Am Coll Cardiol, 46, pp.2168~2182 (2005)
- Yu CM, "Tissue Doppler echocardiographic evidence of reverse remodeling and improved synchronicity by simultaneously delaying regional contraction after biventricular pacing therapy in heart failure", Circulation, 105, pp.438~445 (2002)
- Mele D, "Current role of echocardiography in cardiac resynchronization therapy", Heart Fail Rev, 22, pp.699~722 (2017)
- Bertini M, "Impact of clinical and echocardiographic response to cardiac resynchronization therapy on long-term survival", Eur Heart J Cardiovasc Imaging, 14, pp.774~781 (2013)
- Donal E, "Left atrial reverse remodeling and cardiac resynchronization therapy for chronic heart failure patients in sinus rhythm", J Am Soc Echocardiogr, 22, pp.1152~1158 (2009)
- Yu CM, "Improvement of atrial function and atrial reverse remodeling after cardiac resynchronization therapy for heart failure", J Am Coll Cardiol, 50, pp.778~785 (2007)
- D’Andrea A, "Different effects of cardiac resynchronization therapy on left atrial function in patients with either idiopathic or ischaemic dilated cardiomyopathy: a two-dimensional speckle strain study", Eur Heart J, 28, pp.2738~2748 (2007)
- Nagueh SF, "Doppler tissue imaging : a noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures", J Am Coll Cardiol, 30, pp.1527~1533 (1997)
- Marwick TH, "The role of echocardiography in heart failure", J Nucl Med, 56(Suppl 4), pp.31S~38S (2015)
- Brignole M, "2013ESC guidelines on cardiac pacing and cardiac resynchronization therapy: the task force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA)", Eur Heart J, 34, pp.2281~2329 (2013)
- Mullens W, "Tissue Doppler imaging in the estimation of intracardiac filling pressure in decompensated patients with advanced systolic heart failure", Circulation, 119, pp.62~70 (2009)
- Kloosterman M, "Atrial reverse remodelling is associated with outcome of cardiac resynchronization therapy", Europace, 18, pp.1211~1219 (2016)
- Anwar AM, "Left atrial Frank-Starling law assessed by real-time, three-dimensional echocardiographic left atrial volume changes", Heart, 93, pp.1393~1397 (2007)
- Obokata M, "Incremental diagnostic value of la strain with leg lifts in heart failure with preserved ejection fraction", JACC Cardiovasc Imaging, 6, pp.749~758 (2013)
- Pan G, "Effect of periodic pacemaker optimization on left atrial reverse remodeling in long-term cardiac resynchronization therapy", J Interv Card Electrophysiol, 39, pp.87~93 (2014)
- Mullens W, "Insights from a cardiac resynchronization optimization clinic as part of a heart failure disease management program", J Am Coll Cardiol, 53, pp.765~773 (2009)
- Mullens W, "Importance of adjunctive heart failure optimization immediately after implantation to improve long-term outcomes with cardiac resynchronization therapy", Am J Cardiol, 108, pp.409~415 (2011)
- Hu Y, "Efficient preloading of the ventricles by a properly timed atrial contraction underlies stroke work improvement in the acute response to cardiac resynchronization therapy", Heart Rhythm, 10, pp.1800~1806 (2013)