Pregled bibliografske jedinice broj: 454143
Detecting Volume Responders prior to Implantation of a Cardiac Resynchronization Therapy Device via Minithoracotomy : The Septal Flash as a Predictor of Immediate Left Ventricular Reverse Remodeling
Detecting Volume Responders prior to Implantation of a Cardiac Resynchronization Therapy Device via Minithoracotomy : The Septal Flash as a Predictor of Immediate Left Ventricular Reverse Remodeling // The heart surgery forum, 12 (2009), 6; E362-E367 doi:10.1532/HSF98.20091129 (međunarodna recenzija, članak, znanstveni)
CROSBI ID: 454143 Za ispravke kontaktirajte CROSBI podršku putem web obrasca
Naslov
Detecting Volume Responders prior to Implantation of a Cardiac Resynchronization Therapy Device via Minithoracotomy : The Septal Flash as a Predictor of Immediate Left Ventricular Reverse Remodeling
Autori
Čikeš, Maja ; Bijnens, Bart ; Đurić, Željko ; Lovrić Benčić, Martina ; Gošev, Igor ; Velagić, Vedran ; Gašparović, Hrvoje ; Miličić, Davor ; Biočina, Bojan
Izvornik
The heart surgery forum (1098-3511) 12
(2009), 6;
E362-E367
Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni
Ključne riječi
cardiac resynchronization therapy; Intraoperative echocardiography; Left ventricular function; Left ventricular reverse remodeling; Doppler myocardial imaging
Sažetak
Although cardiac resynchronization therapy (CRT) is well established as adjunctive heart failure treatment, a 30% rate of non-responders poses a challenge to improve the detection of potential responders prior to device implantation. A mechanism based approach to patient selection has been previously proposed, part of which suggests the septal flash as a sign of intraventricular dyssynchrony, predictive of CRT responsiveness. In this pilot study, data from 5 consecutive patients (2F/3M, 62±9 years) referred for CRT implantation via a mini-thoracotomy were analyzed. Intraoperative transthoracic and/or transesophageal echocardiography as well as Doppler myocardial imaging data were acquired pre- and post-CRT device activation. The septal flash was defined as an early ventricular inward and outward septal motion within the isovolumic contraction period, imaged using gray-scale or Tissue Doppler color M-mode. Reverse remodeling was defined as a reduction of end-systolic volume (LVESV) ≥10%. The right atrial and ventricular leads were placed transvenously, while the LV screw-in lead was positioned epicardially on the lateral wall. The septal flash was detected preoperatively in all patients and resolved immediately after onset of biventricular pacing. Immediately following pacemaker activation, a significant reduction of LVESV (248±99 ml vs.190±100 ml, p=0.01) and increase in EF (19±5% vs. 28±5%, p=0.01) were measured in all patients. Likewise, a significant increase of post-activation dP/dt measured noninvasively from the mitral regurgitation trace was noted in all patients (298.6±58.0 mmHg/s vs. 601.7±111.2 mmHg/s, p=0.001). Preoperative presence of the septal flash is a valid predictor of response to CRT. Immediately after CRT device activation, the septal flash disappears and LV reverse remodeling and an increase in contractility are observed.
Izvorni jezik
Engleski
Znanstvena područja
Kliničke medicinske znanosti
POVEZANOST RADA
Projekti:
108-1081875-1991 - Doppler miokarda u ranom otkrivanju i praćenju kardiovaskularnih bolesti (Šeparović-Hanževački, Jadranka, MZOS ) ( CroRIS)
108-1081875-1993 - Otpornost na antitrombocitne lijekove u ishemijskoj bolesti srca i mozga (Miličić, Davor, MZOS ) ( CroRIS)
214-1980976-0974 - HEMOSTATSKI MENADŽMENT VISOKORIZIČNOG KARDIOKIRURŠKOG BOLESNIKA (Biočina, Bojan, MZOS ) ( CroRIS)
Ustanove:
Medicinski fakultet, Zagreb,
Klinički bolnički centar Zagreb,
Zdravstveno veleučilište, Zagreb
Profili:
Vedran Velagić
(autor)
Davor Miličić
(autor)
Bojan Biočina
(autor)
Martina Lovrić Benčić
(autor)
Maja Čikeš
(autor)
Hrvoje Gašparović
(autor)
Citiraj ovu publikaciju:
Časopis indeksira:
- Current Contents Connect (CCC)
- Web of Science Core Collection (WoSCC)
- Science Citation Index Expanded (SCI-EXP)
- SCI-EXP, SSCI i/ili A&HCI
- Scopus
- MEDLINE