PMID- 17161254
OWN - NLM
STAT- MEDLINE
DCOM- 20070111
LR  - 20070529
IS  - 1558-3597 (Electronic)
IS  - 0735-1097 (Linking)
VI  - 48
IP  - 11
DP  - 2006 Dec 5
TI  - Cardiac resynchronization therapy in patients with a narrow QRS complex.
PG  - 2243-50
AB  - OBJECTIVES: The purpose of this study was to evaluate the effects of cardiac 
      resynchronization therapy (CRT) in heart failure patients with narrow QRS complex 
      (<120 ms) and evidence of left ventricular (LV) dyssynchrony on tissue Doppler 
      imaging (TDI). BACKGROUND: Cardiac resynchronization therapy is beneficial in 
      selected heart failure patients with wide QRS complex (> or =120 ms). Patients 
      with narrow QRS complex are currently not eligible for CRT, and the potential 
      effects of CRT are not well studied. METHODS: Thirty-three consecutive patients 
      with narrow QRS complex and 33 consecutive patients with wide QRS complex 
      (control group) were prospectively included. All patients needed to have LV 
      dyssynchrony > or =65 ms on TDI, New York Heart Association (NYHA) functional 
      class III/IV heart failure, and LV ejection fraction < or =35%. RESULTS: Baseline 
      characteristics, particularly LV dyssynchrony, were comparable between patients 
      with narrow and wide QRS complex (110 +/- 8 ms vs. 175 +/- 22 ms; p = NS). No 
      significant relationship was observed between baseline QRS duration and LV 
      dyssynchrony (r = 0.21; p = NS). The improvement in clinical symptoms and LV 
      reverse remodeling was comparable between patients with narrow and wide QRS 
      complex (mean NYHA functional class reduction 0.9 +/- 0.6 vs. 1.1 +/- 0.6 [p = 
      NS] and mean LV end-systolic volume reduction 39 +/- 34 ml vs. 44 +/- 46 ml [p = 
      NS]). CONCLUSIONS: Cardiac resynchronization therapy appears to be beneficial in 
      patients with narrow QRS complex and severe LV dyssynchrony on TDI, with similar 
      improvement in symptoms and comparable LV reverse remodeling to patients with 
      wide QRS complex. The current results need confirmation in larger patient 
      cohorts.
FAU - Bleeker, Gabe B
AU  - Bleeker GB
AD  - Department of Cardiology, Leiden University Medical Center, Leiden, The 
      Netherlands.
FAU - Holman, Eduard R
AU  - Holman ER
FAU - Steendijk, Paul
AU  - Steendijk P
FAU - Boersma, Eric
AU  - Boersma E
FAU - van der Wall, Ernst E
AU  - van der Wall EE
FAU - Schalij, Martin J
AU  - Schalij MJ
FAU - Bax, Jeroen J
AU  - Bax JJ
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20061109
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
CIN - J Am Coll Cardiol. 2007 May 8;49(18):1899; author reply 1899-900. PMID: 17481450
MH  - Aged
MH  - Cardiac Output, Low/complications/physiopathology
MH  - *Cardiac Pacing, Artificial
MH  - *Electrocardiography
MH  - Female
MH  - Heart Diseases/complications/diagnosis/*physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Severity of Illness Index
MH  - Treatment Outcome
MH  - Ultrasonography, Doppler
MH  - Ventricular Dysfunction, Left/complications/diagnosis/physiopathology/therapy
MH  - Ventricular Remodeling
EDAT- 2006/12/13 09:00
MHDA- 2007/01/12 09:00
CRDT- 2006/12/13 09:00
PHST- 2006/04/06 00:00 [received]
PHST- 2006/07/14 00:00 [revised]
PHST- 2006/07/27 00:00 [accepted]
PHST- 2006/12/13 09:00 [pubmed]
PHST- 2007/01/12 09:00 [medline]
PHST- 2006/12/13 09:00 [entrez]
AID - S0735-1097(06)02452-1 [pii]
AID - 10.1016/j.jacc.2006.07.067 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2006 Dec 5;48(11):2243-50. doi: 10.1016/j.jacc.2006.07.067. 
      Epub 2006 Nov 9.