부산대학교 도서관

Introduction: Cardiac resynchronization therapy (CRT) can improve symptoms and left ventricular (LV) function in patients with end- stage heart failure and LV dyssynchrony. It has been reported that CRT also causes reverse remodelling of the LV.It is still unclear if CRT also leads in reverse remodelling of the right ventricle (RV).The aim of this study was to evaluate RV remodelling after 11 months of CRT treatment.Methods: We included 32 consecutive patients with end-stage heart failure, 24 male, mean age 63±15 with cardiomyopathy underwent first-time ICD implantation based on the classical criteria. 19 with coronary artery disease (CAD) and 13 with dilated cardiomyopathy (DC) EF ≤30%, left bundle branch block with QRS duration >130 ms and dyssynchrony. ECHO-Measurements: LV Volumes and RV chamber size were assessed at baseline and after 14 months of CRT. Simpsonʼs technique was used for LV volumes calculating. LV Volumes: Mean End Diastolic Volume: 267±98ml Mean End-Systolic volume: 218±91ml For assessing RV chamber size we measured the following parameters in the apical four chamber view:1) RV long axis: from tricuspid annulus to RV apex RVLA, 2) RV short axis: from ventricular septum to RV free wall at the middle of the RV, RVSA and 3) tricuspid annulus diameter TVANResults: CRT led to significant remodelling of the LV after 11 months.End-diastolic LV volume from 267±98ml to 240±76 ml, p<0.001 and End-systolic LV volume from 218±91 to 167±81 ml, p<0.001.RV chamber size also presented a significant decrease at 11 months of therapy. RVLA from 93 to 88 mm p<0.001 RVSA from 31 to 29 mm, p<0.01 and TVAN from 39 to 35mm,p<0.01. Patients with end-stage heart failure due to DC presented the highest level of RV remodelling.Conclusions: CRT can cause significant reverse remodelling of the left and of the right ventricle after 11 months of therapy. For RV remodelling most benefit was observed in patients with heart failure due to dilated cardiomyopathy.