PMID- 21834852
OWN - NLM
STAT- MEDLINE
DCOM- 20120424
LR  - 20120201
IS  - 1540-8159 (Electronic)
IS  - 0147-8389 (Linking)
VI  - 34
IP  - 11
DP  - 2011 Nov
TI  - Effect of cardiac resynchronization on gradient reduction in patients with 
      obstructive hypertrophic cardiomyopathy: preliminary study.
PG  - 1544-52
LID - 10.1111/j.1540-8159.2011.03193.x [doi]
AB  - BACKGROUND: The purpose of this study was to assess the effectiveness of cardiac 
      resynchronization therapy (CRT) in terms of outflow tract gradient reduction and 
      functional improvement in symptomatic patients with hypertrophic obstructive 
      cardiomyopathy (HOCM) requiring implantable cardioverter-defibrillator (ICD) 
      implantation. METHODS: Eleven consecutive symptomatic HOCM patients with a 
      significant (>/=40 mmHg) gradient and indications for ICD, but without indications 
      for resynchronization, underwent CRT-D implantation. Nine of them (four female, 
      median age of 50 years) in whom the procedure succeeded were screened for New 
      York Heart Association (NYHA) class, outflow gradient, mechanical dyssynchrony, 
      QRS-width change, and 6-minute walking distance (6MWD) and peak oxygen 
      consumption (VO(2)peak) improvement after 6 months and remotely. RESULTS: After 6 
      months of pacing, NYHA class decreased (median 1 vs 2, respectively); peak (33 vs 
      84 mmHg) and mean (13 vs 38 mmHg) outflow tract gradients were reduced; and QRS 
      width (143 vs 105 ms), intraventricular dyssynchrony (35 vs 55 ms), and VO(2)peak 
      (19.5 vs 14.2 mL/kg/min) increased significantly (all P < 0.05) compared to 
      baseline. In six of nine patients (67%), the peak gradient was reduced >50% and 
      reached <40 mmHg. After a median of 36 months, the outflow gradient decreased 
      even more (8 mmHg) and was significantly (P < 0.05) lower than after 6 months of 
      CRT. CONCLUSIONS: These preliminary data suggest that CRT seems to be an 
      effective method of reducing the outflow tract gradient and improving the 
      functional status of symptomatic HOCM patients requiring ICD implantation. Our 
      findings need to be confirmed by more extensive studies.
FAU - Lenarczyk, Radoslaw
AU  - Lenarczyk R
AD  - Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Medical 
      University of Silesia, Silesian Center for Heart Disease, Zabrze, Poland. 
      elfizab@poczta.onet.pl
FAU - Wozniak, Aleksandra
AU  - Wozniak A
FAU - Kowalski, Oskar
AU  - Kowalski O
FAU - Sokal, Adam
AU  - Sokal A
FAU - Pruszkowska-Skrzep, Patrycja
AU  - Pruszkowska-Skrzep P
FAU - Sredniawa, Beata
AU  - Sredniawa B
FAU - Szulik, Mariola
AU  - Szulik M
FAU - Zielinska, Teresa
AU  - Zielinska T
FAU - Kukulski, Tomasz
AU  - Kukulski T
FAU - Stabryla, Joanna
AU  - Stabryla J
FAU - Mazurek, Michal
AU  - Mazurek M
FAU - Bialkowski, Jacek
AU  - Bialkowski J
FAU - Kalarus, Zbigniew
AU  - Kalarus Z
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
MH  - Adolescent
MH  - Aged
MH  - Cardiomyopathy, Hypertrophic/complications/*diagnosis/*prevention & control
MH  - Child
MH  - *Defibrillators, Implantable
MH  - Female
MH  - Heart Failure/complications/*diagnosis/*prevention & control
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pilot Projects
MH  - Treatment Outcome
EDAT- 2011/08/13 06:00
MHDA- 2012/04/25 06:00
CRDT- 2011/08/13 06:00
PHST- 2011/08/13 06:00 [entrez]
PHST- 2011/08/13 06:00 [pubmed]
PHST- 2012/04/25 06:00 [medline]
AID - 10.1111/j.1540-8159.2011.03193.x [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2011 Nov;34(11):1544-52. doi: 
      10.1111/j.1540-8159.2011.03193.x.