PMID- 30616001
OWN - NLM
STAT- MEDLINE
DCOM- 20200720
LR  - 20200720
IS  - 1532-8430 (Electronic)
IS  - 0022-0736 (Linking)
VI  - 53
DP  - 2019 Mar-Apr
TI  - Electrical remodelling post cardiac resynchronization therapy in patients with 
      ischemic and non-ischemic heart failure.
PG  - 44-51
LID - S0022-0736(18)30485-0 [pii]
LID - 10.1016/j.jelectrocard.2018.12.001 [doi]
AB  - BACKGROUND: The beneficial effects of cardiac resynchronization therapy (CRT) in 
      heart failure are largely considered to be due to improved mechanical 
      contractility. The contributory role of electrical remodelling is less clear. We 
      sought to evaluate the impact of electrical remodelling in these patients. 
      METHODS: 33 patients with conventional indications for CRT and with ischemic 
      (ICM) (n = 17) and non-ischemic (NICM) (n = 16) aetiologies for heart failure 
      were prospectively recruited. Functional parameters of peak exercise oxygen 
      consumption (VO(2)max) and Minnesota quality of life (QOL) score, 
      echocardiographic measures of LV functions and parameters of electrical 
      remodelling, e.g. intrinsic QRS duration (iQRSD), intracardiac conduction times 
      of LV pacing to RV electrocardiogram (LVp-RVegm), were measured at CRT implant 
      and after 6 months. RESULTS: Only two electrical parameters predicted functional 
      or symptomatic improvement. LVp-RVegm reduction significantly correlated with 
      improvement in VO(2)max (r = -0.42, p = 0.03 while reduction in iQRSD 
      significantly correlated with improvement in QOL score (r = 0.39, p = 0.04). The 
      extent of changes in LVp-RVegm and iQRSD was significantly greater in NICM than 
      in ICM patients (p = 0.017 and p = 0.042 for heterogeneity). There was also 
      significant differential impact on QOL score in the NICM relative to the ICM 
      group (p = 0.003) but none with VO(2)max. On multivariate analysis, only 
      non-ischemic aetiology was a significant determinant of reduction in iQRSD. 
      CONCLUSION: CRT induces potentially beneficial reduction in LVp-RVegm and iQRSD, 
      which are seen selectively in NICM rather than ICM patients. The extent of 
      improvement in these markers is associated with some functional and symptomatic 
      measures of CRT efficacy.
CI  - Crown Copyright (c) 2018. Published by Elsevier Inc. All rights reserved.
FAU - Ajaero, Chukwudiebube N
AU  - Ajaero CN
AD  - The Queen Elizabeth Hospital, 28 Woodville road, Woodville South 5011, South 
      Australia, Australia.
FAU - Ganesan, Anand
AU  - Ganesan A
AD  - Southern Adelaide Local Health Network, Flinders University of South Australia, 
      Flinders Drive, Bedford Park 5042, South Australia, Australia.
FAU - Horowitz, John D
AU  - Horowitz JD
AD  - The Queen Elizabeth Hospital/Basil Hetzel Institute, 28 Woodville Rd, Woodville 
      South 5011, South Australia, Australia.
FAU - McGavigan, Andrew D
AU  - McGavigan AD
AD  - Flinders Medical Centre, Flinders Drive, Bedford Park 5042, South Australia, 
      Australia. Electronic address: Andrew.McGavigan@sa.gov.au.
LA  - eng
PT  - Journal Article
DEP - 20181204
PL  - United States
TA  - J Electrocardiol
JT  - Journal of electrocardiology
JID - 0153605
SB  - IM
MH  - Aged
MH  - *Cardiac Resynchronization Therapy
MH  - Echocardiography
MH  - Electrocardiography
MH  - Exercise Test
MH  - Female
MH  - Heart Conduction System/*physiopathology
MH  - Heart Failure/*physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Oxygen Consumption/physiology
MH  - Prospective Studies
MH  - Quality of Life
MH  - *Ventricular Remodeling
OTO - NOTNLM
OT  - Cardiac resynchronization therapy
OT  - Cardiopulmonary exercise testing
OT  - Electrical remodelling
OT  - Intracardiac conduction time
OT  - Intracardiac electrocardiogram
OT  - Intrinsic QRS duration
EDAT- 2019/01/08 06:00
MHDA- 2020/07/21 06:00
CRDT- 2019/01/08 06:00
PHST- 2018/07/13 00:00 [received]
PHST- 2018/11/20 00:00 [revised]
PHST- 2018/12/03 00:00 [accepted]
PHST- 2019/01/08 06:00 [pubmed]
PHST- 2020/07/21 06:00 [medline]
PHST- 2019/01/08 06:00 [entrez]
AID - S0022-0736(18)30485-0 [pii]
AID - 10.1016/j.jelectrocard.2018.12.001 [doi]
PST - ppublish
SO  - J Electrocardiol. 2019 Mar-Apr;53:44-51. doi: 10.1016/j.jelectrocard.2018.12.001. 
      Epub 2018 Dec 4.