Left ventricular response after cardiac resynchronization therapy is related to early left atrial volume reduction

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 retrospecti...

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Main Authors: In-Jeong Cho, Jae-Sun Uhm, Jaewon Oh, Jong-Ho Nam, Hee Tae Yu, Taehoon Kim, Boyoung Joung, Seok-Min Kang
Format: Article
Language:English
Published: The Korean Association of Internal Medicine 2020-09-01
Series:The Korean Journal of Internal Medicine
Subjects:
Online Access:http://www.kjim.org/upload/pdf/kjim-2018-430.pdf
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author In-Jeong Cho
Jae-Sun Uhm
Jaewon Oh
Jong-Ho Nam
Hee Tae Yu
Taehoon Kim
Boyoung Joung
Seok-Min Kang
author_facet In-Jeong Cho
Jae-Sun Uhm
Jaewon Oh
Jong-Ho Nam
Hee Tae Yu
Taehoon Kim
Boyoung Joung
Seok-Min Kang
author_sort In-Jeong Cho
collection DOAJ
description 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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spelling doaj.art-7100a3936e6a459bb3cd1a26452380d92022-12-21T18:39:26ZengThe Korean Association of Internal MedicineThe Korean Journal of Internal Medicine1226-33032005-66482020-09-013551125113510.3904/kjim.2018.430170299Left ventricular response after cardiac resynchronization therapy is related to early left atrial volume reductionIn-Jeong Cho0Jae-Sun Uhm1Jaewon Oh2Jong-Ho Nam3Hee Tae Yu4Taehoon Kim5Boyoung Joung6Seok-Min Kang7 Division of Cardiology, Department of Internal Medicine, Ewha Womans University Seoul Hospital, Seoul, Korea Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, KoreaBackground/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.http://www.kjim.org/upload/pdf/kjim-2018-430.pdfatrial remodelingventricular remodelingcardiac resynchronization therapy
spellingShingle In-Jeong Cho
Jae-Sun Uhm
Jaewon Oh
Jong-Ho Nam
Hee Tae Yu
Taehoon Kim
Boyoung Joung
Seok-Min Kang
Left ventricular response after cardiac resynchronization therapy is related to early left atrial volume reduction
The Korean Journal of Internal Medicine
atrial remodeling
ventricular remodeling
cardiac resynchronization therapy
title Left ventricular response after cardiac resynchronization therapy is related to early left atrial volume reduction
title_full Left ventricular response after cardiac resynchronization therapy is related to early left atrial volume reduction
title_fullStr Left ventricular response after cardiac resynchronization therapy is related to early left atrial volume reduction
title_full_unstemmed Left ventricular response after cardiac resynchronization therapy is related to early left atrial volume reduction
title_short Left ventricular response after cardiac resynchronization therapy is related to early left atrial volume reduction
title_sort left ventricular response after cardiac resynchronization therapy is related to early left atrial volume reduction
topic atrial remodeling
ventricular remodeling
cardiac resynchronization therapy
url http://www.kjim.org/upload/pdf/kjim-2018-430.pdf
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