Respondent or non-respondent comparison post cardiac resynchronisation therapy implantation in patients with dilated cardiomyopathy

Authors

  • Bidyut Roy Department Of Cardiology, IPGMER And SSKM Hospital, Kolkata, West Bengal, India https://orcid.org/0000-0002-6876-0044
  • M. Azizul Haque Department Of Cardiology, CNMC, Kolkata, West Bengal, India
  • Kaushik Paul Department Of Cardiology, IPGMER And SSKM Hospital, Kolkata, West Bengal, India
  • Sankar Chandra Mandal Department Of Cardiology, IPGMER And SSKM Hospital, Kolkata, West Bengal, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20233016

Keywords:

Respondent, Non-respondent, Post CRT, Dilated cardiomyopathy

Abstract

Background: Dilated cardiomyopathy can be treated using cardiac resynchronisation therapy (CRT) effectively. In our study, we compared the clinical and biochemical profile of responders and non-responders to CRT device (CRTD) implantation suffering from DCM.

Methods: A cross-sectional observational study was performed in 47 patients with dilated cardiomyopathy for CRTD implantation for a period of 18 months. The tools used for the study include electrocardiography 12 lead, echocardiography: 2D, M mode, Doppler, strain echo, Holter monitoring, coronary angiography and CRTD implantation. Statistical analysis was performed using Epi Info (TM) 7.2.2.2.

Results: The proportion of responders (68.1%) was significantly higher than non-responder (31.9%). Almost 60% of patients in non-responder group had smoking as a risk factor. Around 60% were suffering from hypertension and 33% from T2DM in non-respondent group. Parameters of dyssynchrony has significantly improved in responder group than in non-responder group. LVEDV, LVESV has shown an increase and EF has decreased considerably in DCM patients. Many patients in non-responder category have shown mitral and tricuspid regurgitation. Strain echocardiography parameters-GLS, GRS and GCS were significantly decreased. Post CRTD echocardiographic parameter has improved considerably and LVESV was reduced in more than 15% of responders.

Conclusions: The CRTD implantation improves patients’ clinical and Echocardiographic data which can help in better patient management, improving quality of life and decreased healthcare cost. By this study we can improve patients’ selection and predict accordingly for CRT responders and non-responders and can take necessary measures for better patient’s management.

References

Schultheiss HP, Fairweather D, Caforio ALP, Escher F, Hershberger RE, Lipshultz SE, et al. Dilated cardiomyopathy. Nat Rev Dis Primers. 2019;5(1):32.

Watson RDS. ABC of heart failure: Clinical features and complications. BMJ. 2000;320(7229):236-9.

Park CS, Park JJ, Mebazaa A, Oh I, Park H, Cho H, et al. Characteristics, outcomes, and treatment of heart failure with improved ejection fraction. J Am Heart Assoc. 2019;8(6):011077.

Inamdar A, Inamdar A. Heart failure: diagnosis, management and utilization. J Clin Med. 2016;5(7):62.

Owen JS, Khatib S, Morin DP. Cardiac resynchronization therapy. Ochsner J. 2009;9(4):248-56.

Stătescu C, Ureche C, Enachi Ș, Radu R, Sascău RA. Cardiac resynchronization therapy in non-ischemic cardiomyopathy: role of multimodality imaging. Diagnostics (Basel). 2021;11(4):625.

Jaffe LM, Morin DP. Cardiac resynchronization therapy: history, present status, and future directions. Ochsner J. 2014;14(4):596-607.

van Stipdonk A, Wijers S, Meine M, et al. ECG patterns in cardiac resynchronization therapy. J Atr Fibrillation. 2015;7(6):1214.

Naik A, Singh B, Yadav R, Pandurangi U, Kler TS, Shankar B, et al. Cardiac resynchronization therapy is associated with improvement in clinical outcomes in Indian heart failure patients: Results of a large, long-term observational study. Indian Heart J. 2018;70(3):377-383.

Bijl P, Kostyukevich MV, Khidir M, Marsan NA, Delgado V, Bax JJ, et al. Left ventricular remodelling and change in left ventricular global longitudinal strain after cardiac resynchronization therapy: prognostic implications. Eur Heart J Cardiovasc Imaging. 2019;20(10):1112-9.

Appadurai V, Elia N, Mew T, Tomlinson S, Chan J, Hamilton-Craig C, et al. Global longitudinal strain as a prognostic marker in cardiac resynchronisation therapy: A systematic review. Int J Cardiol Heart Vasc. 2021;35:100849.

Delgado V, Ypenburg C, Zhang Q, Mollema SA, Fung JW, Schalij MJ, et al. Changes in global left ventricular function by multidirectional strain assessment in heart failure patients undergoing cardiac resynchronization therapy. J Am Soc Echocardiogr. 2009;22(6):688-94.

Orszulak M, Filipecki A, Wrobel W, Berger-Kucza A, Orszulak W, Urbanczyk-Swic D, et al. Left ventricular global longitudinal strain in predicting CRT response: one more J-shaped curve in medicine. Heart Vessels. 2021;36(7):999-1008.

Andrea A, Caso P, Scarafile R, et al. Effects of global longitudinal strain and total scar burden on response to cardiac resynchronization therapy in patients with ischaemic dilated cardiomyopathy. European Journal of Heart Failure. 2009;11:58-67.

Roes SD, Mollema SA, Lamb HJ,. Validation of echocardiographic two-dimensional speckle tracking longitudinal strain imaging for viability assessment in patients with chronic ischemic left ventricular dysfunction and comparison with contrast-enhanced magnetic resonance imaging. Am J Cardiol. 2009;10:4312-7.

Rosendahl L, Blomstrand P, Brudin L. Longitudinal peak strain detects a smaller risk area than visual assessment of wall motion in acute myocardial infarction. Cardiovasc Ultrasound. 2010;11:1476-7120.

Hasselberg N, Haugaa K, Bernard A. Left ventricular markers of mortality and ventricular arrhythmias in heart failure patients with cardiac resynchronization therapy. Eur Heart J Cardiovasc Imaging. 2015;11:17343-350.

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Published

2023-09-29

How to Cite

Roy, B., Haque, M. A., Paul, K., & Mandal, S. C. (2023). Respondent or non-respondent comparison post cardiac resynchronisation therapy implantation in patients with dilated cardiomyopathy. International Journal of Research in Medical Sciences, 11(10), 3667–3671. https://doi.org/10.18203/2320-6012.ijrms20233016

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Section

Original Research Articles