PMID- 17161255
OWN - NLM
STAT- MEDLINE
DCOM- 20070111
LR  - 20161124
IS  - 1558-3597 (Electronic)
IS  - 0735-1097 (Linking)
VI  - 48
IP  - 11
DP  - 2006 Dec 5
TI  - Benefits of cardiac resynchronization therapy for heart failure patients with 
      narrow QRS complexes and coexisting systolic asynchrony by echocardiography.
PG  - 2251-7
AB  - OBJECTIVES: This study was designed to evaluate the role of cardiac 
      resynchronization therapy (CRT) in heart failure (HF) patients with narrow QRS 
      complexes (<120 ms) and echocardiographic evidence of mechanical asynchrony. 
      BACKGROUND: Cardiac resynchronization therapy is currently recommended to 
      advanced HF patients with prolonged QRS duration. Echocardiographic assessment of 
      systolic mechanical asynchrony has been proven useful to predict a favorable 
      response after CRT. METHODS: A total of 102 HF patients with New York Heart 
      Association (NYHA) functional class III or IV were enrolled. Among them, 51 had 
      wide QRS (>120 ms) and 51 had narrow QRS (<120 ms). Tissue Doppler imaging (TDI) 
      was employed to select patients with systolic asynchrony (increased asynchrony 
      index) in the narrow-QRS group. Clinical and echocardiographic assessments were 
      performed at baseline and 3 months after CRT. RESULTS: There was a significant 
      reduction of left ventricular (LV) end-systolic volume in both narrow (122 +/- 42 
      cc vs. 103 +/- 47 cc, p < 0.001) and wide (148 +/- 74 cc vs. 112 +/- 64 cc, p < 
      0.001) QRS groups. Improvement of NYHA functional class (both p < 0.001), maximal 
      exercise capacity (both p < 0.05), 6-min hall-walk distance (both p < 0.01), 
      ejection fraction (both p < 0.001), and mitral regurgitation (both p < 0.005) was 
      also observed. In both groups, the degree of baseline mechanical asynchrony 
      determined LV reverse remodeling to a similar extent, as shown by the 
      superimposed regression lines. Withholding CRT for 4 weeks resulted in loss of 
      echocardiographic benefits. CONCLUSIONS: Cardiac resynchronization therapy for HF 
      patients with narrow QRS complexes and coexisting mechanical asynchrony by TDI 
      results in LV reverse remodeling and improvement of clinical status. The 
      amplitude of benefit is similar to the wide-QRS group provided that similar 
      extent of systolic asynchrony is selected.
FAU - Yu, Cheuk-Man
AU  - Yu CM
AD  - Division of Cardiology, S. H. Ho Cardiovascular and Stroke Centre, Institute of 
      Vascular Medicine, Department of Medicine and Therapeutics, Prince of Wales 
      Hospital, The Chinese University of Hong Kong, Hong Kong, China. cmyu@cuhk.edu.hk
FAU - Chan, Yat-Sun
AU  - Chan YS
FAU - Zhang, Qing
AU  - Zhang Q
FAU - Yip, Gabriel W K
AU  - Yip GW
FAU - Chan, Chi-Kin
AU  - Chan CK
FAU - Kum, Leo C C
AU  - Kum LC
FAU - Wu, LiWen
AU  - Wu L
FAU - Lee, Alex Pui-Wai
AU  - Lee AP
FAU - Lam, Yat-Yin
AU  - Lam YY
FAU - Fung, Jeffrey Wing-Hong
AU  - Fung JW
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
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  - Arrhythmias, Cardiac/*complications/*diagnostic imaging
MH  - Cardiac Output, Low/complications/diagnosis/*physiopathology/*therapy
MH  - *Cardiac Pacing, Artificial
MH  - *Echocardiography
MH  - *Electrocardiography
MH  - Female
MH  - Heart/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Severity of Illness Index
MH  - Treatment Outcome
MH  - Ventricular Function, Left
MH  - Ventricular Remodeling
EDAT- 2006/12/13 09:00
MHDA- 2007/01/12 09:00
CRDT- 2006/12/13 09:00
PHST- 2006/05/08 00:00 [received]
PHST- 2006/07/14 00:00 [revised]
PHST- 2006/07/17 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)02210-8 [pii]
AID - 10.1016/j.jacc.2006.07.054 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2006 Dec 5;48(11):2251-7. doi: 10.1016/j.jacc.2006.07.054.