Journal Article

Standard haemodynamic measurements

Jürgen Vogt, Johannes Heintze, Barbara Lamp, Bert Hansky and Dieter Horstkotte

in European Heart Journal Supplements

Published on behalf of European Society of Cardiology

Volume 6, issue suppl_D, pages D29-D34
Published in print August 2004 | ISSN: 1520-765X
Published online August 2004 | e-ISSN: 1554-2815 | DOI: http://dx.doi.org/10.1016/j.ehjsup.2004.05.004
Standard haemodynamic measurements

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Aims Several studies on the acute effect of cardiac resynchronization in patients with advanced heart failure (HF) and left bundle branch block (LBBB) have shown that left and biventricular stimulation increase pulse pressure and contractility, while patients with a QRS complex [math]150 ms may deteriorate during stimulation.

Methods and results Patients with LBBB, severe HF and a QRS width [math]150 ms underwent right, left and biventricular stimulation at different AV delays. Acute response was defined as 10% pulse pressure increase. 165 of 188 patients (88%) in sinus rhythm (47 women, mean age 62.5±10 years, ejection fraction 23±8%, NYHA class 3.1±0.3) were regarded acute responders. 10% of 103 patients with dilated cardiomyopathy and 16.5% of 79 patients with coronary artery disease were considered non-responders. 29 patients (81%) with two posterolateral veins were acute responders with 10 of them (33%) being responders in only one vein. 54 patients had an atrio-left ventricular pulse pressure increase of 10.7±10.6%, 9.8±6.4% in 48 patients with atrio-biventricular stimulation. At one-year follow-up, heart failure had significantly improved from NYHA class 3.1±0.4 to 2.1±0.7 ([math]), VO2peak from 12.7±2.8 to 15.9±3.6 ml/min/kg. Left ventricular enddiastolic diameter being an indicator of reverse remodelling decreased from 80.5±10.5 to 73.3±13 ([math]).

Conclusion Haemodynamic testing before CRT allows the identification of acute non-responders as well as the best mode and site of stimulation and the optimal atrioventricular delay in responders.

Keywords: Heart failure; Resynchronization; Stimulation site; Stimulation mode; Pulse pressure; Responder

Journal Article.  2790 words.  Illustrated.

Subjects: Cardiovascular Medicine

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