Effects of Cardiac Resynchronization Therapy on Diastolic Function: Evaluation by Radionuclide Angiography |
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Authors: | GIUSEPPE BORIANI MD PhD CINZIA VALZANIA MD FRANCESCO FALLANI MD MAURO BIFFI MD CRISTIAN MARTIGNANI MD PhD DAVIDE SAPORITO MD MATTEO ZIACCHI MD IGOR DIEMBERGER MD CRISTIANO GRECO MD MATTEO BERTINI MD GIULIA DOMENICHINI MD MAURIZIO LEVORATO MD † ROBERTO FRANCHI MD † ANGELO BRANZI MD |
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Institution: | From the Institute of Cardiology, University of Bologna;, and Department of Nuclear Medicine, S.Orsola-Malpighi Hospital, Bologna, Italy |
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Abstract: | While the beneficial effects of cardiac resynchronization therapy (CRT) on left ventricular (LV) systolic function have been demonstrated, no information is available regarding its effects on LV diastolic function during exercise. Using radionuclide angiography, we prospectively evaluated the effects of CRT on diastolic function at rest and during exercise in 15 patients consecutively referred for CRT. All patients underwent equilibrium Tc99 radionuclide angiography with bicycle exercise performed (1) at baseline; (2) immediately after CRT implantation, in spontaneous rhythm and during CRT; and (3) after 3 months of biventricular stimulation. Diastolic function was assessed by measurements of peak filling rate (PFR). At baseline, activation of biventricular stimulation influenced PFR neither at rest (1.06 ± 0.34 vs 1.07 ± 0.50 mL/s during spontaneous rhythm, P = 0.9) nor during exercise (1.45 ± 0.62 vs 1.33 ± 0.48 mL/s, P = 0.3). At 3 months, improvements were observed in New York Heart Association functional class and systolic function. By contrast, no improvement in diastolic function was observed either at rest (PFR = 1.11 ± 0.45 vs 1.07 ± 0.50 mL/s in spontaneous rhythm at baseline, P = 0.6) or during exercise (1.23 ± 0.50 vs 1.33 ± 0.48 mL/s, P = 0.2). These observations indicate that the intermediate benefits conferred by CRT on LV systolic function at rest and during exercise were not accompanied by similar improvements in diastolic function . |
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Keywords: | congestive heart failure cardiac resynchronization therapy diastolic function |
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