PMID- 26879720
OWN - NLM
STAT- MEDLINE
DCOM- 20160525
LR  - 20181202
IS  - 0376-2491 (Print)
IS  - 0376-2491 (Linking)
VI  - 96
IP  - 3
DP  - 2016 Jan 19
TI  - [Influence of diastolic filling pattern on the efficacy of cardiac 
      resynchronization therapy in patients with non-ischemic cardiomyopathy].
PG  - 189-94
LID - 10.3760/cma.j.issn.0376-2491.2016.03.008 [doi]
AB  - OBJECTIVE: To investigate the influence of diastolic filling pattern on the 
      efficacy of cardiac resynchronization therapy (CRT) in patients with non-ischemic 
      cardiomyopathy. METHODS: Between January 2012 and September 2013, 100 patients 
      with non-ischemic cardiomyopathy undergoing CRT were enrolled in the study, and 
      all patients were grouped by the pre-CRT diastolic filling pattern as impaired 
      relaxation, pseudonormalized and restrictive filling. After follow up for 12 
      months, the New York Heart Association (NYHA) Class and echocardiography were 
      used to assess the efficacy of CRT.The endpoint was rehospitalization for heart 
      failure or cardiac death. Kaplan-Meier survival curves were plotted to assess 
      prognosis. RESULTS: All patients had varying degrees of diastolic 
      dysfunction.Logistic regression analysis indicated that diastolic filling pattern 
      was the independent factor for the response of CRT.(1)The response rate (78.7%) 
      of impaired relaxation group (n=61) was significantly higher than that of the 
      other two groups (P<0.01); postoperative NYHA class, left ventricular ejection 
      fraction (LVEF), fraction shortening (FS), left ventricular end-systolic volume 
      (LVESV) and left ventricular end-diastolic volume (LVEDV) were significantly 
      improved (all P<0.01). (2)For pseudonormalized group (n=18), at the 3(rd) month, 
      NYHA class decreased from 3.3+/-0.5 to 2.3+/-0.5, LVEF increased from 27%+/-7% to 
      31%+/-6% (both P<0.01), and FS improved significantly (P<0.05); no significant 
      decrease of LVEDV and LVESV was found. At the 6(th) month, LVEF improved 
      significantly (P<0.01); LVESV was reduced (P<0.05). (3)In restrictive filling 
      group (n=21), CRT brought short-term improvement in NYHA class but did not induce 
      any significant improvement in LVEF, FS, LVESV and LVEDV.At the 6(th) month, 
      there were significant differences in efficacy among the three groups (P<0.05). 
      At the end of follow-up, 5 patients died, and the cumulative endpoint incidence 
      was significantly higher in restrictive filling group (81%) than the other two 
      groups (P<0.05). CONCLUSIONS: In patients with moderate-to-severe heart failure, 
      left ventricular diastolic dysfunction affects the efficacy of CRT, patients with 
      impaired relaxation benefit significantly, pseudonormalized patients take longer 
      to benefit, but patients with restrictive filling do not benefit from CRT.
FAU - Wang, Qi
AU  - Wang Q
AD  - Department of Cardiology, Provincial Hospital Affiliated to Anhui Medical 
      University, Hefei 230001, China.
FAU - Chen, Kangyu
AU  - Chen K
FAU - Yu, Fei
AU  - Yu F
FAU - Su, Hao
AU  - Su H
FAU - An, Chunshei
AU  - An C
FAU - Hu, Yang
AU  - Hu Y
FAU - Yang, Dongmei
AU  - Yang D
FAU - Xu, Jian
AU  - Xu J
FAU - Yan, Ji
AU  - Yan J
LA  - chi
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - China
TA  - Zhonghua Yi Xue Za Zhi
JT  - Zhonghua yi xue za zhi
JID - 7511141
SB  - IM
MH  - *Cardiac Resynchronization Therapy
MH  - *Cardiomyopathies
MH  - *Diastole
MH  - Echocardiography
MH  - Heart Failure
MH  - Humans
MH  - Incidence
MH  - Kaplan-Meier Estimate
MH  - Prognosis
MH  - Stroke Volume
MH  - Ventricular Function, Left
EDAT- 2016/02/18 06:00
MHDA- 2016/05/26 06:00
CRDT- 2016/02/17 06:00
PHST- 2016/02/17 06:00 [entrez]
PHST- 2016/02/18 06:00 [pubmed]
PHST- 2016/05/26 06:00 [medline]
AID - 10.3760/cma.j.issn.0376-2491.2016.03.008 [doi]
PST - ppublish
SO  - Zhonghua Yi Xue Za Zhi. 2016 Jan 19;96(3):189-94. doi: 
      10.3760/cma.j.issn.0376-2491.2016.03.008.