Acute improvement of functional mitral regurgitation in patients with advanced systolic heart failure, receiving a biventricular pacemaker

Abstract

Cardiac resynchronization therapy (CRT) improves synchronization of LV segmental contraction.Our puprose is to investigate the acute impact of CRT on mitral regurgitation using validated quantitative echocardiographic methods. Methods Fourteen patients presenting with severely impaired LV systolic function (NYHA class >= III, EF< 35%,QRS 165±15 msec), were studied before and 24 hours after implantation of a CRT system. EF(%) and stroke volume (SV) are calculated by m-Mode and Simpson's method.The severety of MR was quantified according to (1) the volumetric method, (2) the flow-convergence method with a hemispherical assumption. Regurgitant volume (RV) was calculated as RV=mitral regurgitant orifice area* VTI, where VTI is the velocity time integral of the regurgitant flow as determined by CW Doppler, and by calculating MR jet area/left atrial area by colour Doppler. Statistical analysis was performed with the Wilcoxon Matched Pairs Test . View this table: Conclusion CRT acutely reduces the severety of functional MR and this effect is independent from geometrical changes(reverse remodelling).