open access

Vol 72, No 6 (2014)
Original articles
Published online: 2014-06-11
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Effect of cardiac resynchronisation therapy on coronary blood flow in patients with non-ischaemic dilated cardiomyopathy

Jarosław Kaźmierczak, Małgorzata Peregud-Pogorzelska, Jarosław Gorący, Andrzej Wojtarowicz, Radosław Kiedrowicz, Zdzisława Kornacewicz-Jach
DOI: 10.5603/KP.a2014.0019
·
Kardiol Pol 2014;72(6):511-518.

open access

Vol 72, No 6 (2014)
Original articles
Published online: 2014-06-11

Abstract

Background: Cardiac resynchronisation therapy (CRT) has beneficial effects on cardiac function, exercise tolerance, symptoms, and prognosis. Coronary blood flow impairment has been observed in patients with non-ischaemic dilated cardiomyopathy (DCM) despite angiographically normal coronary arteries. No data are available on coronary blood flow and coronary flow reserve (CFR) measured by intracoronary Doppler in different coronary arteries in patients with DCM and left bundle branch block (LBBB) before and during treatment with CRT.

Aim: Thus, the major aim of our study was to assess the effect of CRT on coronary blood flow in patients with non-ischaemic DCM and to compare coronary blood flow and CFR measured in the 3 major coronary arteries (left anterior descending [LAD], left circumflex [LCX], and right coronary artery [RCA]).

Methods: Twenty one patients with DCM and LBBB (mean left ventricular ejection fraction 26 ± 7%, 5 females, mean age 57.8 ± 8.1 years) were studied. Average peak velocity, diastolic/systolic velocity ratio and CFR were measured using intracoronary Doppler before and 6–9 months after implantation of CRT-D or CRT-P.

Results: In patients with a clinical improvement (71.4%), CFR increased in LAD. CFR measured in LCX and RCA did notimprove either in the overall study group or in patients with a clinical improvement. The observed increase in CFR in LAD correlated only with reduction of QRS duration.

Conclusions: In non-ischaemic DCM, CFR is reduced only in LAD. A significant improvement of CFR in LAD after CRT correlates with reduction of QRS duration.

Abstract

Background: Cardiac resynchronisation therapy (CRT) has beneficial effects on cardiac function, exercise tolerance, symptoms, and prognosis. Coronary blood flow impairment has been observed in patients with non-ischaemic dilated cardiomyopathy (DCM) despite angiographically normal coronary arteries. No data are available on coronary blood flow and coronary flow reserve (CFR) measured by intracoronary Doppler in different coronary arteries in patients with DCM and left bundle branch block (LBBB) before and during treatment with CRT.

Aim: Thus, the major aim of our study was to assess the effect of CRT on coronary blood flow in patients with non-ischaemic DCM and to compare coronary blood flow and CFR measured in the 3 major coronary arteries (left anterior descending [LAD], left circumflex [LCX], and right coronary artery [RCA]).

Methods: Twenty one patients with DCM and LBBB (mean left ventricular ejection fraction 26 ± 7%, 5 females, mean age 57.8 ± 8.1 years) were studied. Average peak velocity, diastolic/systolic velocity ratio and CFR were measured using intracoronary Doppler before and 6–9 months after implantation of CRT-D or CRT-P.

Results: In patients with a clinical improvement (71.4%), CFR increased in LAD. CFR measured in LCX and RCA did notimprove either in the overall study group or in patients with a clinical improvement. The observed increase in CFR in LAD correlated only with reduction of QRS duration.

Conclusions: In non-ischaemic DCM, CFR is reduced only in LAD. A significant improvement of CFR in LAD after CRT correlates with reduction of QRS duration.

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Keywords

cardiac resynchronisation therapy, heart failure, dilated cardiomyopathy, coronary blood flow, coronary flow reserve

About this article
Title

Effect of cardiac resynchronisation therapy on coronary blood flow in patients with non-ischaemic dilated cardiomyopathy

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 72, No 6 (2014)

Pages

511-518

Published online

2014-06-11

DOI

10.5603/KP.a2014.0019

Bibliographic record

Kardiol Pol 2014;72(6):511-518.

Keywords

cardiac resynchronisation therapy
heart failure
dilated cardiomyopathy
coronary blood flow
coronary flow reserve

Authors

Jarosław Kaźmierczak
Małgorzata Peregud-Pogorzelska
Jarosław Gorący
Andrzej Wojtarowicz
Radosław Kiedrowicz
Zdzisława Kornacewicz-Jach

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