The influence of myocardial scar and dyssynchrony on reverse remodeling in cardiac resynchronization therapy

A.H. Jansen; F.A.L.E. Bracke; J.M. Dantzig, van; C.H. Peels; J.C. Post; H.C.M. Bosch, van den; L.M. Gelder, van; A. Meijer; H. Korsten; J. Vries, de; N.M. Hemel, van

doi:10.1016/j.euje.2007.07.002

The influence of myocardial scar and dyssynchrony on reverse remodeling in cardiac resynchronization therapy

A.H. Jansen, F.A.L.E. Bracke, J.M. Dantzig, van, C.H. Peels, J.C. Post, H.C.M. Bosch, van den, L.M. Gelder, van, A. Meijer, H. Korsten, J. Vries, de, N.M. Hemel, van

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Aim: The influence of location and extent of transmural scar and its relation with dyssynchrony in cardiac resynchronization therapy (CRT) was investigated as posterolateral scar tissue has been invoked as a cause of non-response to CRT. Methods and results: Fifty-seven patients eligible for CRT were assessed for transmural scar with gadolinium-enhanced MRI and for left ventricular (LV) dyssynchrony with tissue Doppler. After implant, both atrioventricular and interventricular pacing intervals were optimized. LV reverse remodeling was defined as 10% decrease in LV end-systolic volume after 3 months. Sixteen patients had transmural scar in the posterolateral (PL) area (LV lead location), 14 at a remote site (non-PL) and 27 patients had no scar. LV reverse remodeling was observed in respectively 25%, 64% and 89% (P = 0.0001). Univariate analyses showed a relation with LV dyssynchrony (P = 0.004) and with absence of PL scar (P = 0.04) but not with QRS duration and the extent of LV scar tissue. In multivariate analysis, only LV dyssynchrony (OR: 19.62; 95% CI: 2.5–151.9; P = 0.004) independently predicted LV reverse remodeling. Conclusion: In this study LV dyssynchrony remains the most important determinant of response to CRT, even in the presence of posterolateral scar provided atrioventricular and interventricular pacing intervals are optimized.

Original language	English
Pages (from-to)	483-488
Number of pages	5
Journal	European Journal of Echocardiography
Volume	9
Issue number	4
DOIs	https://doi.org/10.1016/j.euje.2007.07.002
Publication status	Published - 2008

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10.1016/j.euje.2007.07.002

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Jansen, A. H., Bracke, F. A. L. E., Dantzig, van, J. M., Peels, C. H., Post, J. C., Bosch, van den, H. C. M., Gelder, van, L. M., Meijer, A., Korsten, H., Vries, de, J., & Hemel, van, N. M. (2008). The influence of myocardial scar and dyssynchrony on reverse remodeling in cardiac resynchronization therapy. European Journal of Echocardiography, 9(4), 483-488. https://doi.org/10.1016/j.euje.2007.07.002

Jansen, A.H. ; Bracke, F.A.L.E. ; Dantzig, van, J.M. ; Peels, C.H. ; Post, J.C. ; Bosch, van den, H.C.M. ; Gelder, van, L.M. ; Meijer, A. ; Korsten, H. ; Vries, de, J. ; Hemel, van, N.M. / The influence of myocardial scar and dyssynchrony on reverse remodeling in cardiac resynchronization therapy. In: European Journal of Echocardiography. 2008 ; Vol. 9, No. 4. pp. 483-488.

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title = "The influence of myocardial scar and dyssynchrony on reverse remodeling in cardiac resynchronization therapy",

abstract = "Aim: The influence of location and extent of transmural scar and its relation with dyssynchrony in cardiac resynchronization therapy (CRT) was investigated as posterolateral scar tissue has been invoked as a cause of non-response to CRT. Methods and results: Fifty-seven patients eligible for CRT were assessed for transmural scar with gadolinium-enhanced MRI and for left ventricular (LV) dyssynchrony with tissue Doppler. After implant, both atrioventricular and interventricular pacing intervals were optimized. LV reverse remodeling was defined as 10% decrease in LV end-systolic volume after 3 months. Sixteen patients had transmural scar in the posterolateral (PL) area (LV lead location), 14 at a remote site (non-PL) and 27 patients had no scar. LV reverse remodeling was observed in respectively 25%, 64% and 89% (P = 0.0001). Univariate analyses showed a relation with LV dyssynchrony (P = 0.004) and with absence of PL scar (P = 0.04) but not with QRS duration and the extent of LV scar tissue. In multivariate analysis, only LV dyssynchrony (OR: 19.62; 95% CI: 2.5–151.9; P = 0.004) independently predicted LV reverse remodeling. Conclusion: In this study LV dyssynchrony remains the most important determinant of response to CRT, even in the presence of posterolateral scar provided atrioventricular and interventricular pacing intervals are optimized.",

author = "A.H. Jansen and F.A.L.E. Bracke and {Dantzig, van}, J.M. and C.H. Peels and J.C. Post and {Bosch, van den}, H.C.M. and {Gelder, van}, L.M. and A. Meijer and H. Korsten and {Vries, de}, J. and {Hemel, van}, N.M.",

year = "2008",

doi = "10.1016/j.euje.2007.07.002",

language = "English",

volume = "9",

pages = "483--488",

journal = "European Journal of Echocardiography",

issn = "1525-2167",

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Jansen, AH, Bracke, FALE, Dantzig, van, JM, Peels, CH, Post, JC, Bosch, van den, HCM, Gelder, van, LM, Meijer, A, Korsten, H, Vries, de, J & Hemel, van, NM 2008, 'The influence of myocardial scar and dyssynchrony on reverse remodeling in cardiac resynchronization therapy', European Journal of Echocardiography, vol. 9, no. 4, pp. 483-488. https://doi.org/10.1016/j.euje.2007.07.002

The influence of myocardial scar and dyssynchrony on reverse remodeling in cardiac resynchronization therapy. / Jansen, A.H.; Bracke, F.A.L.E.; Dantzig, van, J.M.; Peels, C.H.; Post, J.C.; Bosch, van den, H.C.M.; Gelder, van, L.M.; Meijer, A.; Korsten, H.; Vries, de, J.; Hemel, van, N.M.

In: European Journal of Echocardiography, Vol. 9, No. 4, 2008, p. 483-488.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - The influence of myocardial scar and dyssynchrony on reverse remodeling in cardiac resynchronization therapy

AU - Jansen, A.H.

AU - Bracke, F.A.L.E.

AU - Dantzig, van, J.M.

AU - Peels, C.H.

AU - Post, J.C.

AU - Bosch, van den, H.C.M.

AU - Gelder, van, L.M.

AU - Meijer, A.

AU - Korsten, H.

AU - Vries, de, J.

AU - Hemel, van, N.M.

PY - 2008

Y1 - 2008

N2 - Aim: The influence of location and extent of transmural scar and its relation with dyssynchrony in cardiac resynchronization therapy (CRT) was investigated as posterolateral scar tissue has been invoked as a cause of non-response to CRT. Methods and results: Fifty-seven patients eligible for CRT were assessed for transmural scar with gadolinium-enhanced MRI and for left ventricular (LV) dyssynchrony with tissue Doppler. After implant, both atrioventricular and interventricular pacing intervals were optimized. LV reverse remodeling was defined as 10% decrease in LV end-systolic volume after 3 months. Sixteen patients had transmural scar in the posterolateral (PL) area (LV lead location), 14 at a remote site (non-PL) and 27 patients had no scar. LV reverse remodeling was observed in respectively 25%, 64% and 89% (P = 0.0001). Univariate analyses showed a relation with LV dyssynchrony (P = 0.004) and with absence of PL scar (P = 0.04) but not with QRS duration and the extent of LV scar tissue. In multivariate analysis, only LV dyssynchrony (OR: 19.62; 95% CI: 2.5–151.9; P = 0.004) independently predicted LV reverse remodeling. Conclusion: In this study LV dyssynchrony remains the most important determinant of response to CRT, even in the presence of posterolateral scar provided atrioventricular and interventricular pacing intervals are optimized.

AB - Aim: The influence of location and extent of transmural scar and its relation with dyssynchrony in cardiac resynchronization therapy (CRT) was investigated as posterolateral scar tissue has been invoked as a cause of non-response to CRT. Methods and results: Fifty-seven patients eligible for CRT were assessed for transmural scar with gadolinium-enhanced MRI and for left ventricular (LV) dyssynchrony with tissue Doppler. After implant, both atrioventricular and interventricular pacing intervals were optimized. LV reverse remodeling was defined as 10% decrease in LV end-systolic volume after 3 months. Sixteen patients had transmural scar in the posterolateral (PL) area (LV lead location), 14 at a remote site (non-PL) and 27 patients had no scar. LV reverse remodeling was observed in respectively 25%, 64% and 89% (P = 0.0001). Univariate analyses showed a relation with LV dyssynchrony (P = 0.004) and with absence of PL scar (P = 0.04) but not with QRS duration and the extent of LV scar tissue. In multivariate analysis, only LV dyssynchrony (OR: 19.62; 95% CI: 2.5–151.9; P = 0.004) independently predicted LV reverse remodeling. Conclusion: In this study LV dyssynchrony remains the most important determinant of response to CRT, even in the presence of posterolateral scar provided atrioventricular and interventricular pacing intervals are optimized.

U2 - 10.1016/j.euje.2007.07.002

DO - 10.1016/j.euje.2007.07.002

M3 - Article

C2 - 17826355

VL - 9

SP - 483

EP - 488

JO - European Journal of Echocardiography

JF - European Journal of Echocardiography

SN - 1525-2167

IS - 4

ER -

The influence of myocardial scar and dyssynchrony on reverse remodeling in cardiac resynchronization therapy

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