PMID- 32879130 OWN - NLM STAT- MEDLINE DCOM- 20200924 LR - 20200924 IS - 1672-7347 (Print) IS - 1672-7347 (Linking) VI - 45 IP - 6 DP - 2020 Jun 28 TI - Correlation between cardiac resynchronization response and pulmonary artery hemodynamic parameters. PG - 715-721 LID - 1672-7347(2020)06-0715-07 [pii] LID - 10.11817/j.issn.1672-7347.2020.190520 [doi] AB - OBJECTIVES: To evaluate the response to cardiac resynchronization therapy (CRT) and the correlation between CRT and pulmonary artery hemodynamic parameters. METHODS: The patients with chronic heart failure indicator for CRT were enrolled. The left ventricular end-systolic volume (LVESV) was measured by echocardiography and New York Heart Association (NYHA) classification was evaluated between one week before and six months after CRT. Mean pulmonary artery pressure (mPAP), pulmonary artery systolic pressure (PASP) and pulmonary vascular resistance (PVR) were measured by right heart catheterization. Left ventricular reverse remodeling (LVRR) is defined as a decrease of 15% or more in LVESV at the 6th month after CRT; Clinical response is defined as a decrease of NYHA classification at or above grade 1 at the 6th month after CRT. Pulmonary hypertension (PH) was defined as mPAP>/=25 mmHg. According to the response, patients were divided into 3 groups: group A (LVRR+clinical response), group B (no LVRR+clinical response) and group C (no LVRR+no clinical response). The changes of NYHA classification, echocardiographic and pulmonary hemodynamic parameters were observed in the 3 groups. The Kaplan-Meier survival curve was used to analyze the differences in all-cause mortality, combined end-point events of death or re-hospitalization due to heart failure among different groups. RESULTS: A total of 45 patients with CRT implantation [aged (63.27+/-9.55) years, 36 males] were included. The average follow-up period was (33.76+/-11.50) months. Thirty-one patients (68.89%) were in group A, 9 of whom with PH. Eight patients (17.78%) were in group B, 7 of whom with PH. Six patients were in group C, all with PH. Cardiac function including NYHA classification, echocardiographic and pulmonary hemodynamic parameters had been significantly improved in group A after CRT implantation (P<0.05). In group B, NYHA classification and pulmonary hemodynamic parameters were decreased significantly (P<0.05), but echocardiographic parameters did not change obviously (P>0.05). There were no significant changes in NYHA classification, echocardiographic and pulmonary hemodynamic parameters in group C (P>0.05). Compared with group C, group A and group B had lower all-cause mortality (P=0.005) and lower incidence of composite endpoint events (P=0.001). CONCLUSIONS: Patients with LVRR and clinical response after CRT have a good prognosis. Patients with clinical response but without LVRR have a better prognosis than those without clinical response and LVRR, which may be related to the decrease of pulmonary hemodynamic parameters such as mPAP and TPG. FAU - Li, Jiangjin AU - Li J AD - Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029. ljh197202@sina.com. AD - Department of Cardiology, Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huai'an Jiangsu 223300, China. ljh197202@sina.com. FAU - Qian, Zhiyong AU - Qian Z AD - Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029. FAU - Qiu, Henghao AU - Qiu H AD - Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029. FAU - Jiang, Zeyu AU - Jiang Z AD - Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029. FAU - Wang, Yao AU - Wang Y AD - Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029. FAU - Zhao, Hao AU - Zhao H AD - Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029. FAU - Zhang, Haifeng AU - Zhang H AD - Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029. FAU - Zhou, Yanli AU - Zhou Y AD - Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029. FAU - Hou, Xiaofeng AU - Hou X AD - Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029. FAU - Li, Xinli AU - Li X AD - Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029. FAU - Zou, Jiangang AU - Zou J AD - Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029. jgzou@njmu.edu.cn. LA - eng LA - chi GR - BE2016764/Clinical Frontier Technology of Jiangsu Provincial Department of Science and Technology, China/ PT - Journal Article TT - 心脏再同步化治疗反应性和肺动脉血流动力学参数的相关性. PL - China TA - Zhong Nan Da Xue Xue Bao Yi Xue Ban JT - Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences JID - 101230586 SB - IM MH - Aged MH - *Cardiac Resynchronization Therapy MH - Heart Failure/*therapy MH - Hemodynamics MH - Humans MH - Male MH - Middle Aged MH - Pulmonary Artery MH - Treatment Outcome MH - Ventricular Remodeling OTO - NOTNLM OT - cardiac resynchronization therapy OT - heart failure OT - pulmonary hypertension OT - response EDAT- 2020/09/04 06:00 MHDA- 2020/09/25 06:00 CRDT- 2020/09/04 06:00 PHST- 2020/09/04 06:00 [entrez] PHST- 2020/09/04 06:00 [pubmed] PHST- 2020/09/25 06:00 [medline] AID - 1672-7347(2020)06-0715-07 [pii] AID - 10.11817/j.issn.1672-7347.2020.190520 [doi] PST - ppublish SO - Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2020 Jun 28;45(6):715-721. doi: 10.11817/j.issn.1672-7347.2020.190520.