Abnormal diastolic function underlies the different beneficial effects of cardiac resynchronization therapy on ischemic and non-ischemic cardiomyopathy

Authors

  • Qi Wang Anhui University; Department of Cardiology
  • Kang-Yu Chen Anhui University; Department of Cardiology
  • Fei Yu Anhui University; Department of Cardiology
  • Hao Su Anhui University; Department of Cardiology
  • Chun-Sheng An Anhui University; Department of Cardiology
  • Yang Hu Anhui University; Department of Cardiology
  • Dong-Mei Yang Anhui University; Department of Cardiology
  • Jian Xu Anhui University; Department of Cardiology
  • Ji Yan Cardiovascular Institute of Anhui

DOI:

https://doi.org/10.6061/clinics/2017(07)08

Keywords:

Heart Failure, Cardiac Resynchronization Therapy, Diastole

Abstract

OBJECTIVES: To investigate the association between diastolic function and the different beneficial effects of cardiac resynchronization therapy in patients with heart failure due to different causes. METHODS: The 104 enrolled patients were divided into an ischemic cardiomyopathy group (n=27) and a non-ischemic cardiomyopathy group (n=77) according to the cause of heart failure. Before implantation, left ventricular diastolic function was evaluated in all patients using echocardiography. After six months of follow-up, the beneficial effects of cardiac resynchronization therapy were evaluated using a combination of clinical symptoms and echocardiography parameters. RESULTS: The ischemic cardiomyopathy group included significantly more patients with restrictive filling than the non-ischemic cardiomyopathy group. The response rate after the implantation procedure was significantly higher in the non-ischemic cardiomyopathy group than in the ischemic cardiomyopathy group. Degrees of improvement in echocardiography parameters were significantly greater in the non-ischemic cardiomyopathy group than in the ischemic cardiomyopathy group. Multivariate regression analysis showed that a restrictive filling pattern was an independent factor that influenced responses to cardiac resynchronization therapy. CONCLUSIONS: This study again confirmed that the etiology of heart failure affects the beneficial effects of cardiac resynchronization therapy and a lower degree of improvement in ventricular systolic function and remodelling was observed in ischemic cardiomyopathy patients than in non-ischemic cardiomyopathy patients. In addition, systolic heart failure patients with severe diastolic dysfunction had poor responses to cardiac resynchronization therapy. Ischemic cardiomyopathy patients exhibited more severe diastolic dysfunction than non-ischemic cardiomyopathy patients, which may be a reason for the reduced beneficial effect of cardiac resynchronization therapy.

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Published

2017-07-01

Issue

Section

Clinical Sciences

How to Cite

Abnormal diastolic function underlies the different beneficial effects of cardiac resynchronization therapy on ischemic and non-ischemic cardiomyopathy. (2017). Clinics, 72(7), 432-437. https://doi.org/10.6061/clinics/2017(07)08