Can Right Heart Catheterization Improve the Prediction of Positive Response to Resynchronization Therapy?

<b>Background/Objectives</b>: Cardiac resynchronization therapy (CRT) is one of the interventional methods of heart failure (HF) treatment, with the criteria for CRT device implantation based on the value of the left ventricular ejection fraction, New York Heart Association functional cl...

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Main Authors: Karolina Barańska-Pawełczak, Wojciech Jacheć, Andrzej Tomasik, Bettina Ziaja, Michalina Mazurkiewicz, Tomasz Kukulski, Celina Wojciechowska
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/13/2/467
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author Karolina Barańska-Pawełczak
Wojciech Jacheć
Andrzej Tomasik
Bettina Ziaja
Michalina Mazurkiewicz
Tomasz Kukulski
Celina Wojciechowska
author_facet Karolina Barańska-Pawełczak
Wojciech Jacheć
Andrzej Tomasik
Bettina Ziaja
Michalina Mazurkiewicz
Tomasz Kukulski
Celina Wojciechowska
author_sort Karolina Barańska-Pawełczak
collection DOAJ
description <b>Background/Objectives</b>: Cardiac resynchronization therapy (CRT) is one of the interventional methods of heart failure (HF) treatment, with the criteria for CRT device implantation based on the value of the left ventricular ejection fraction, New York Heart Association functional class, QRS complex duration, and electrocardiographic morphology. Pulmonary hypertension is an important factor influencing the prognosis of patients with HF, but its influence on CRT is not fully understood. <b>Aim:</b> The main aim of the study was to determine the prognostic value of baseline right heart catheterization-derived parameters on the response to CRT. <b>Methods</b>: It was a single-centre study with retrospective analysis of data of 39 non-ischemic HF patients. Clinical, biochemical, echocardiographic, electrocardiographic, and hemodynamic data were obtained before the CRT device implantation, and after 6 months of follow-up, non-invasive re-assessment was performed. Various criteria for the response to CRT were assessed along with the correlation between the baseline parameters. <b>Results</b>: After follow-up, a significant difference was found in the reduction in symptoms associated with HF, an increase achieved in the six-minute walk test distance, and a reduction in N-terminal pro-brain natriuretic peptide concentration as well as improvement of LV function assessed in echocardiographic examination. Among all parameters assessed, the baseline higher value of the transpulmonary gradient and pulmonary vascular resistance most often had a significant negative impact on meeting the criteria of response to CRT. <b>Conclusions</b>: The results of the analyses show that the initial assessment of pulmonary hemodynamics may be crucial in predicting the response to CRT in patients with non-ischemic cardiomyopathy.
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spelling doaj-art-e49f0ed5bcb9496b905d254a15c6a5bc2025-08-20T03:11:20ZengMDPI AGBiomedicines2227-90592025-02-0113246710.3390/biomedicines13020467Can Right Heart Catheterization Improve the Prediction of Positive Response to Resynchronization Therapy?Karolina Barańska-Pawełczak0Wojciech Jacheć1Andrzej Tomasik2Bettina Ziaja3Michalina Mazurkiewicz4Tomasz Kukulski5Celina Wojciechowska6Department of Cardiology, Specialistic Hospital in Zabrze, 41-800 Zabrze, PolandSecond Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, PolandSecond Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, PolandDepartment of Cardiology, Specialistic Hospital in Zabrze, 41-800 Zabrze, PolandDepartment of Cardiology, Specialistic Hospital in Zabrze, 41-800 Zabrze, PolandSecond Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, PolandSecond Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland<b>Background/Objectives</b>: Cardiac resynchronization therapy (CRT) is one of the interventional methods of heart failure (HF) treatment, with the criteria for CRT device implantation based on the value of the left ventricular ejection fraction, New York Heart Association functional class, QRS complex duration, and electrocardiographic morphology. Pulmonary hypertension is an important factor influencing the prognosis of patients with HF, but its influence on CRT is not fully understood. <b>Aim:</b> The main aim of the study was to determine the prognostic value of baseline right heart catheterization-derived parameters on the response to CRT. <b>Methods</b>: It was a single-centre study with retrospective analysis of data of 39 non-ischemic HF patients. Clinical, biochemical, echocardiographic, electrocardiographic, and hemodynamic data were obtained before the CRT device implantation, and after 6 months of follow-up, non-invasive re-assessment was performed. Various criteria for the response to CRT were assessed along with the correlation between the baseline parameters. <b>Results</b>: After follow-up, a significant difference was found in the reduction in symptoms associated with HF, an increase achieved in the six-minute walk test distance, and a reduction in N-terminal pro-brain natriuretic peptide concentration as well as improvement of LV function assessed in echocardiographic examination. Among all parameters assessed, the baseline higher value of the transpulmonary gradient and pulmonary vascular resistance most often had a significant negative impact on meeting the criteria of response to CRT. <b>Conclusions</b>: The results of the analyses show that the initial assessment of pulmonary hemodynamics may be crucial in predicting the response to CRT in patients with non-ischemic cardiomyopathy.https://www.mdpi.com/2227-9059/13/2/467pulmonary hypertensioncardiac resynchronization therapyright heart catheterization
spellingShingle Karolina Barańska-Pawełczak
Wojciech Jacheć
Andrzej Tomasik
Bettina Ziaja
Michalina Mazurkiewicz
Tomasz Kukulski
Celina Wojciechowska
Can Right Heart Catheterization Improve the Prediction of Positive Response to Resynchronization Therapy?
Biomedicines
pulmonary hypertension
cardiac resynchronization therapy
right heart catheterization
title Can Right Heart Catheterization Improve the Prediction of Positive Response to Resynchronization Therapy?
title_full Can Right Heart Catheterization Improve the Prediction of Positive Response to Resynchronization Therapy?
title_fullStr Can Right Heart Catheterization Improve the Prediction of Positive Response to Resynchronization Therapy?
title_full_unstemmed Can Right Heart Catheterization Improve the Prediction of Positive Response to Resynchronization Therapy?
title_short Can Right Heart Catheterization Improve the Prediction of Positive Response to Resynchronization Therapy?
title_sort can right heart catheterization improve the prediction of positive response to resynchronization therapy
topic pulmonary hypertension
cardiac resynchronization therapy
right heart catheterization
url https://www.mdpi.com/2227-9059/13/2/467
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