Reverse cardiac remodeling in patients with dilated cardiomyopathy post Cardiac Resynchronization Therapy (CRT) and its clinical implication

• DOI: 10.21608/bjas.2021.188843
• Publication Date: 2021-09-01T19:38:30Z
• Authors: K.E. El Rabat; A. El Naggar; S.I. Farag; A.M. Heikal
• Keywords: Dilated Cardiomyopathy

Aim: To track the reverse cardiac remodeling in patients with dilated cardiomyopathy post resynchronization therapy (ON and OFF modes) its implication on clinical condition emphasizing factors achieving that remodeling.Patients Methods: 30 indicated for device were enrolled studied before three to six months after insertion by history taking, examination, transthoracic echocardiogram, ECG minutes' walk test.Results: (23 males 7 females, mean age (54.50 ± 6.24years) implanted CRT.All sinus rhythm, QRS duration ≥120 ms LBBB (ischemic etiology was excluded coronary angiography having risk IHD).There response CRT as NYHA class improved p<0.001 6 min test p<0.001,electrocardiographically, there significant differences HR, PR interval, ,axis morphology between pre measurements (P<0.001) echocardiographic LV volume 80%, EF 76.6% change (∆QRSD) significantly correlated changes NYHA, LVEDD, LVESD, LVEF.s.Area under curve 0.824 ∆QRSD (p=0.005),∆QRSD of ≥-20 a cutoff value had high specificity predicting both Echocardiographic response.Coronary lead selection positioning major role best shown lateral veins (70 % responders ) worst mid vein ( 65 non-responders);Achieving targeted sometimes required more than usual programmable VV delay up 60 some patients.Conclusion: Reverse DCM (CRT ON + modes associated improvement conditions subsequent reduction incidence their need hospital admissions.