Left Ventricular Response After Cardiac Resynchronization Therapy is Related to Early Left Atrial Volume Reduction

Overview

Journal Korean J Intern Med

Specialty General Medicine

Date 2020 Feb 6

PMID 32019293

Citations 1

Authors

In-Jeong Cho

Jae-Sun Uhm

Jaewon Oh

Jong-Ho Nam

Hee Tae Yu

Taehoon Kim

Boyoung Joung

Seok-Min Kang

Affiliations

Soon will be listed here.

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.

Conclusion: 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.

Citing Articles

What does left atrial structural remodeling mean in cardiac resynchronization therapy?.

Shin S Korean J Intern Med. 2020; 35(5):1070-1071.

PMID: 32921008 PMC: 7487307. DOI: 10.3904/kjim.2020.397.

References

Bax J, Abraham T, Barold S, Breithardt O, Fung J, Garrigue S . Cardiac resynchronization therapy: Part 2--issues during and after device implantation and unresolved questions. J Am Coll Cardiol. 2005; 46(12):2168-82. DOI: 10.1016/j.jacc.2005.09.020. View

Kuperstein R, Goldenberg I, Moss A, Solomon S, Bourgoun M, Shah A . Left atrial volume and the benefit of cardiac resynchronization therapy in the MADIT-CRT trial. Circ Heart Fail. 2013; 7(1):154-60. DOI: 10.1161/CIRCHEARTFAILURE.113.000748. View

Solomon S, Foster E, Bourgoun M, Shah A, Viloria E, Brown M . Effect of cardiac resynchronization therapy on reverse remodeling and relation to outcome: multicenter automatic defibrillator implantation trial: cardiac resynchronization therapy. Circulation. 2010; 122(10):985-92. DOI: 10.1161/CIRCULATIONAHA.110.955039. View

Brenyo A, Link M, Barsheshet A, Moss A, Zareba W, Wang P . 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. 2011; 58(16):1682-9. DOI: 10.1016/j.jacc.2011.07.020. View

Mullens W, Kepa J, De Vusser P, Vercammen J, Rivero-Ayerza M, Wagner P . Importance of adjunctive heart failure optimization immediately after implantation to improve long-term outcomes with cardiac resynchronization therapy. Am J Cardiol. 2011; 108(3):409-15. DOI: 10.1016/j.amjcard.2011.03.060. View

Mele D, Bertini M, Malagu M, Nardozza M, Ferrari R . Current role of echocardiography in cardiac resynchronization therapy. Heart Fail Rev. 2017; 22(6):699-722. DOI: 10.1007/s10741-017-9636-1. View

Brignole M, Auricchio A, Baron-Esquivias G, Bordachar P, Boriani G, Breithardt O . 2013 ESC 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.... Eur Heart J. 2013; 34(29):2281-329. DOI: 10.1093/eurheartj/eht150. View

Lang R, Bierig M, Devereux R, Flachskampf F, Foster E, Pellikka P . 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.... J Am Soc Echocardiogr. 2005; 18(12):1440-63. DOI: 10.1016/j.echo.2005.10.005. View

Ghio S, Freemantle N, Scelsi L, Serio A, Magrini G, Pasotti M . Long-term left ventricular reverse remodelling with cardiac resynchronization therapy: results from the CARE-HF trial. Eur J Heart Fail. 2009; 11(5):480-8. DOI: 10.1093/eurjhf/hfp034. View

10.

DAndrea A, Caso P, Romano S, Scarafile R, Riegler L, Salerno G . 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. 2007; 28(22):2738-48. DOI: 10.1093/eurheartj/ehm443. View

11.

Donal E, Tan K, Leclercq C, Ollivier R, Derumeaux G, Bernard M . Left atrial reverse remodeling and cardiac resynchronization therapy for chronic heart failure patients in sinus rhythm. J Am Soc Echocardiogr. 2009; 22(10):1152-8. DOI: 10.1016/j.echo.2009.06.005. View

12.

Yu C, Chau E, Sanderson J, Fan K, Tang M, Fung W . Tissue Doppler echocardiographic evidence of reverse remodeling and improved synchronicity by simultaneously delaying regional contraction after biventricular pacing therapy in heart failure. Circulation. 2002; 105(4):438-45. DOI: 10.1161/hc0402.102623. View

13.

Kloosterman M, Rienstra M, Mulder B, Van Gelder I, Maass A . Atrial reverse remodelling is associated with outcome of cardiac resynchronization therapy. Europace. 2016; 18(8):1211-9. DOI: 10.1093/europace/euv382. View

14.

Hu Y, Gurev V, Constantino J, Trayanova N . 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. 2013; 10(12):1800-6. PMC: 3852188. DOI: 10.1016/j.hrthm.2013.08.003. View

15.

Mathias A, Moss A, McNitt S, Zareba W, Goldenberg I, Solomon S . Clinical Implications of Complete Left-Sided Reverse Remodeling With Cardiac Resynchronization Therapy: A MADIT-CRT Substudy. J Am Coll Cardiol. 2016; 68(12):1268-76. DOI: 10.1016/j.jacc.2016.06.051. View

16.

Yu C, Fang F, Zhang Q, Yip G, Li C, Chan J . Improvement of atrial function and atrial reverse remodeling after cardiac resynchronization therapy for heart failure. J Am Coll Cardiol. 2007; 50(8):778-85. DOI: 10.1016/j.jacc.2007.04.073. View

17.

Pan G, Liu Z, He P, Yang Y, Mu Y, Han W . Effect of periodic pacemaker optimization on left atrial reverse remodeling in long-term cardiac resynchronization therapy. J Interv Card Electrophysiol. 2013; 39(1):87-93. DOI: 10.1007/s10840-013-9833-3. View

18.

Anwar A, Geleijnse M, Soliman O, Nemes A, Ten Cate F . Left atrial Frank-Starling law assessed by real-time, three-dimensional echocardiographic left atrial volume changes. Heart. 2007; 93(11):1393-7. PMC: 2016907. DOI: 10.1136/hrt.2006.099366. View

19.

Nagueh S, Appleton C, Gillebert T, Marino P, Oh J, Smiseth O . Recommendations for the evaluation of left ventricular diastolic function by echocardiography. J Am Soc Echocardiogr. 2009; 22(2):107-33. DOI: 10.1016/j.echo.2008.11.023. View

20.

Nagueh S, Middleton K, Kopelen H, Zoghbi W, Quinones M . Doppler tissue imaging: a noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures. J Am Coll Cardiol. 1997; 30(6):1527-33. DOI: 10.1016/s0735-1097(97)00344-6. View