Influence of Diastolic Filling Pattern on Cardiac Resynchronization Therapy in Patients With Ischemic Cardiomyopathy
10.3969/j.issn.1000-3614.2016.02.012
- VernacularTitle:缺血性心肌病患者舒张充盈模式对心脏再同步治疗疗效的影响
- Author:
Qi WANG
;
Kangyu CHEN
;
Fei YU
;
Hao SU
;
Chunsheng AN
;
Yang HU
;
Dongmei YANG
;
Jian XU
;
Ji YAN
- Publication Type:Journal Article
- Keywords:
Heart failure;
Cardiac resynchronization therapy;
Echocardiography,Doppler
- From:
Chinese Circulation Journal
2016;31(2):151-155
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the inlfuence of diastolic iflling pattern on cardiac resynchronization therapy (CRT) in patients with ischemic cardiomyopathy.
Methods: A total of 61 patients with ischemic cardiomyopathy received CRT in our hospital from 2012-03 to 2014-03 were studied. According to pre-CRT diastolic iflling pattern, the patients were divided into 2 groups:Non-restrictive iflling (NRF) group, n=36 and RF group, n=25. All patients were followed-up for 12 months, based on NYHA classiifcation, CRT efifcacy was assessed by echocardiography;the endpoints included re-hospitalization for heart failure or cardiac death. Kaplan-Meier survival curve was used to assess the prognosis.
Results: ①NRF group had CRT response rate at 66.7%(24/36) which was higher than RF group 28.0%(7/25), (χ2=8.826, P=0.003);the post-operative NYHA classiifcation, LVEF, FS, LVEDV and LVESV were signiifcantly improved, all P<0.01.② RF group showed the improved post-operative NYHA classification, P<0.01, while no obvious changes of LVEF, FS, LVEDV at 6 months after operation, and LVESV increased than it was before, P<0.05. Signiifcant differences were observed between 2 groups at 6 months after operation, P<0.01. Logistic regression analysis indicated that diastolic iflling pattern was the independent impact factor for CRT response. There were 2 patients died during 12 months of follow-up period;the endpoints in RF group was 76.0%(19/25) which was higher than NRF group 44.4%(16/36), (χ2=5.213, P=0.022).
Conclusion: Diastolic iflling pattern affected CRT efifcacy in patients with ischemic cardiomyopathy;NRF patients were more beneifciary for CRT, while RF patients had lower response to CRT which associated to poor prognosis.
