Original aricle Echocardiographic evaluation of patients with severe heart failure and impairment of intraventricular conduction following cardiac resynchronisation therapy

Abstract

Background: Echocardiographic examination is essential for clinical assessment of patients after cardiac resynchronisation therapy (CRT).
Aim:
To assess the benefit of CRT in patients with end-stage heart failure at long-term follow-up.
Methods:
28 patients with end-stage heart failure, NYHA class ≥III (II in patients with indications for implantable cardioverter defibrillator and echocardiographic signs of ventricular mechanical systolic dyssynchrony), left ventricular ejection fraction (LVEF) <35%, QRS duration >120 ms and left bundle branch block morphology received a biventricular device. Standard colour Doppler echocardiography examination was performed at baseline, and then every 6 months, up to 2 years. Parameters of systolic and diastolic LV function, mitral insufficiency and right ventricular (RV) pressure were evaluated. Results: Following CRT, a statistically significant improvement of LV dimensions (p <0.05), and LVEF (p <0.001) was recorded. CRT also resulted in a mitral regurgitation decrement (p <0.01). Interventricular mechanical delay was shortened (p=0.0005). After 2 years, non-significant worsening of LV dimensions was observed. At long-term follow-up CRT did not result in LV volume, left atrium, RV dimension or RV pressure reduction.
Conclusions:CRT is associated with reverse remodelling of the LV at mid-term follow-up.