Clinical, electrical, and functional changes following CRT-P implantation: short-term results in patients with non-ischaemic cardiomyopathy

Aim. Assessment of the correlation between cardiac remodeling, functional status and electrical remodeling after cardiac resynchronisation therapy (CRT) in patients with non-ischaemic cardiomyopathy.Material and methods. A single center, prospective, observational study included 50 patients with non...

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Main Authors: S. A. Mostafa, A. М. Abdelmoneim, H. Ramadan, E. S. Elkeshk
Format: Article
Language:English
Published: Столичная издательская компания 2024-03-01
Series:Рациональная фармакотерапия в кардиологии
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Online Access:https://www.rpcardio.online/jour/article/view/2571
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author S. A. Mostafa
A. М. Abdelmoneim
H. Ramadan
E. S. Elkeshk
author_facet S. A. Mostafa
A. М. Abdelmoneim
H. Ramadan
E. S. Elkeshk
author_sort S. A. Mostafa
collection DOAJ
description Aim. Assessment of the correlation between cardiac remodeling, functional status and electrical remodeling after cardiac resynchronisation therapy (CRT) in patients with non-ischaemic cardiomyopathy.Material and methods. A single center, prospective, observational study included 50 patients with non-ischaemic cardiomyopathy who were candidate for CRT implantation. All patients prior to CRT and then 3 months after implantation had standard 12-lead surface ECGs to assess QRSd for assessment electrical response, for assessment of left ventricular ejection fraction (LVEF) and volumes (left ventricular end diastolic and systolic volume, LVEDV and LVESV), mitral regurgitation (degree of mitral regurgitation), pulmonary artery systolic pressure (for diagnosis of pulmonary hypertension), NYHA class and 6 minute walk test (6MWT) to assess patient’s functional capacity.Results. 50 patients with CRT were included (35 males and 15 females, mean age 54.88±7.48 years). All patients were in sinus rhythm with QRS duration (QRSd) ≥120 ms, EF<35% and left bundle branch block. After 3 months; there was significant improvement in QRSd in 82% of the cases (145.3±16.3 ms vs 133.3±17.2 ms, p<0.001). NYHA class improved at least one class in 78% and 6 min walk test improved in 80% (168.5 [131.0; 181.0] m vs 280.0 [237.0; 297.0] m, p<0.001). LVEF increased significantly in 74% of study cases (28.6±2.7 vs 34.5±3.1, p value 0.001) also there were statistically significant improvement in LVEDV (267.0±45.7 to 221.8±41.9 ml, p=0.002) and LVESV (137.43±47.19 to 105.03±42.7 ml, p=0.003). There was statistically significant correlation between QRSd and NYHA class (r=0.392, p=0.005), QRSd and 6MWT (r=0.323, p=0.022) and QRSd with LVEF (r=0.672 with p<0.001). Only seven patients showed improvement in the 3 parameters: LVESV, QRS duration and 6 min walk test.Conclusion. The CRT-pacemaker implantation was associated with significant improvement in QRSd, NYHA class, 6MWT and LV volumes in the short-term period. QRSd improvement was significantly correlated with functional status and LV EF.
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issn 1819-6446
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series Рациональная фармакотерапия в кардиологии
spelling doaj-art-45a4fe1798404452bdf007716b3fd4cc2025-08-23T10:00:36ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532024-03-01201131810.20996/1819-6446-2024-25712187Clinical, electrical, and functional changes following CRT-P implantation: short-term results in patients with non-ischaemic cardiomyopathyS. A. Mostafa0A. М. Abdelmoneim1H. Ramadan2E. S. Elkeshk3Benha universityBenha univerisityNational Heart InstituteBenha UniversityAim. Assessment of the correlation between cardiac remodeling, functional status and electrical remodeling after cardiac resynchronisation therapy (CRT) in patients with non-ischaemic cardiomyopathy.Material and methods. A single center, prospective, observational study included 50 patients with non-ischaemic cardiomyopathy who were candidate for CRT implantation. All patients prior to CRT and then 3 months after implantation had standard 12-lead surface ECGs to assess QRSd for assessment electrical response, for assessment of left ventricular ejection fraction (LVEF) and volumes (left ventricular end diastolic and systolic volume, LVEDV and LVESV), mitral regurgitation (degree of mitral regurgitation), pulmonary artery systolic pressure (for diagnosis of pulmonary hypertension), NYHA class and 6 minute walk test (6MWT) to assess patient’s functional capacity.Results. 50 patients with CRT were included (35 males and 15 females, mean age 54.88±7.48 years). All patients were in sinus rhythm with QRS duration (QRSd) ≥120 ms, EF<35% and left bundle branch block. After 3 months; there was significant improvement in QRSd in 82% of the cases (145.3±16.3 ms vs 133.3±17.2 ms, p<0.001). NYHA class improved at least one class in 78% and 6 min walk test improved in 80% (168.5 [131.0; 181.0] m vs 280.0 [237.0; 297.0] m, p<0.001). LVEF increased significantly in 74% of study cases (28.6±2.7 vs 34.5±3.1, p value 0.001) also there were statistically significant improvement in LVEDV (267.0±45.7 to 221.8±41.9 ml, p=0.002) and LVESV (137.43±47.19 to 105.03±42.7 ml, p=0.003). There was statistically significant correlation between QRSd and NYHA class (r=0.392, p=0.005), QRSd and 6MWT (r=0.323, p=0.022) and QRSd with LVEF (r=0.672 with p<0.001). Only seven patients showed improvement in the 3 parameters: LVESV, QRS duration and 6 min walk test.Conclusion. The CRT-pacemaker implantation was associated with significant improvement in QRSd, NYHA class, 6MWT and LV volumes in the short-term period. QRSd improvement was significantly correlated with functional status and LV EF.https://www.rpcardio.online/jour/article/view/2571crtcardiac remodelingheart failurenyha class
spellingShingle S. A. Mostafa
A. М. Abdelmoneim
H. Ramadan
E. S. Elkeshk
Clinical, electrical, and functional changes following CRT-P implantation: short-term results in patients with non-ischaemic cardiomyopathy
Рациональная фармакотерапия в кардиологии
crt
cardiac remodeling
heart failure
nyha class
title Clinical, electrical, and functional changes following CRT-P implantation: short-term results in patients with non-ischaemic cardiomyopathy
title_full Clinical, electrical, and functional changes following CRT-P implantation: short-term results in patients with non-ischaemic cardiomyopathy
title_fullStr Clinical, electrical, and functional changes following CRT-P implantation: short-term results in patients with non-ischaemic cardiomyopathy
title_full_unstemmed Clinical, electrical, and functional changes following CRT-P implantation: short-term results in patients with non-ischaemic cardiomyopathy
title_short Clinical, electrical, and functional changes following CRT-P implantation: short-term results in patients with non-ischaemic cardiomyopathy
title_sort clinical electrical and functional changes following crt p implantation short term results in patients with non ischaemic cardiomyopathy
topic crt
cardiac remodeling
heart failure
nyha class
url https://www.rpcardio.online/jour/article/view/2571
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AT amabdelmoneim clinicalelectricalandfunctionalchangesfollowingcrtpimplantationshorttermresultsinpatientswithnonischaemiccardiomyopathy
AT hramadan clinicalelectricalandfunctionalchangesfollowingcrtpimplantationshorttermresultsinpatientswithnonischaemiccardiomyopathy
AT eselkeshk clinicalelectricalandfunctionalchangesfollowingcrtpimplantationshorttermresultsinpatientswithnonischaemiccardiomyopathy