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KMID : 0338420200350051125
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The Korean Journal of Internal Medicine
2020 Volume.35 No. 5 p.1125 ~ p.1135
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Left ventricular response after cardiac resynchronization therapy is related to early left atrial volume reduction
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Cho In-Jeong
Uhm Jae-Sun
Oh Jae-Won
Nam Jong-Ho
Yu Hee-Tae
Kim Tae-Hoon
Joung Bo-Young
Kang Seok-Min
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Abstract
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Background/Aims: The current study aimed to elucidate a time-course change in left atrial volume after cardiac resynchronization therapy (CRT) and to verify factors associated with left atrial volume reduction (LAVR) and its prognostic implications.
Methods: The records of 97 patients were retrospectively reviewed after CRT. Echocardiographic data were analyzed at baseline before CRT, at early follow-up (FU) (≤ 1 year, median 6 months), and at late FU (median 30 months). Left ventricular volume response (LVVR) was defined as 15% reduction in left ventricular (LV) end-systolic volume (ESV). LAVR was classified into two groups by the median value at early FU: LAVR (≥ 7.5%) and no LAVR (< 7.5%).
Results: LV ESV index continuously decreased from baseline to early FU and from early FU to late FU (106.1 ± 47.4 mL/m2 vs. 87.6 ± 51.6 mL/m2 vs. 72.5 ± 57.1 mL/m2). LA volume index decreased from baseline to early FU, but there were no reductions thereafter (51.8 ± 21.9 mL/m2 vs. 45.1 ± 19.6 mL/m2 vs. 44.9 ± 23.0 mL/m2). The only echocardiographic factor associated with LAVR was change in E velocity (odds ratio [OR], 1.04; p = 0.002). Early LAVR (OR, 10.05; p = 0.002) was an independent predictor for late LVVR.
Conclusions: LAVR was related to reduction in E velocity, suggesting its relation with optimization of LV filling pressure. Early LAVR was a predictor for LVVR to CRT in long-term FU.
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KEYWORD
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Atrial remodeling, Ventricular remodeling, Cardiac resynchronization therapy
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