OP-115 IMPROVEMENTS IN RIGHT VENTRICULAR SYSTOLIC FUNCTION AFTER CARDIAC RESYNCHRONIZATION THERAPY ARE COUPLED TO RESPONSE IN LEFT VENTRICULAR SYSTOLIC PERFORMANCE

Abstract

after the procedure. Results: Patients were followed up 27±5 months. 45 patients (64%) were asymptomatic at the follow-up. 5 patients in asymptomatic group had two CPVA procedures (paroxysmal AF; 4, persistant AF; 1). 11 patients with paroxysmal AF had structural heart disease. Success rate was found similar between paroxysmal AF group with and without structural heart disease (70% versus 60%, in respectively, p=0.11). 13 patients with non-paroxysmal AF had structural heart disease. Among the non-paroxysmal AF group, success rate was significantly lower in the patients with structural heart disease (33% versus 50%, p=0.03). Conclusions: Although long-term success rate of the CPVA was significantly lower in non-paroxysmal AF patients with structural heart disease, this procedure is safe and effective in paroxysmal AF patients with or without structural heart disease. Objective: Cardiac resynchronization therapy (CRT) in patients with left ventricular systolic dysfunction and electrical dyssynchrony has been shown to improve left ventricular (LV) systolic performance and hemo- dynamics. Improvement in diastolic dysfunction may contribute to these results. Variable results have been reported about the effects of CRT on diastolic function. Tissue Doppler imaging (TDI) provides rapid assessment of ventricular function and adds incremental value to the standard Doppler- echocardiographic measurements. This study was performed to evaluate the effects of CRT on diastolic function by using tissue Doppler imaging. Methods: A total of 54 patients (mean age, 61.9±10.5; 43 men; mean LV ejection fraction 24.6±4.0%) with New York Heart Association functional class III or IV heart failure symptoms despite maximal medical therapy were included in the study. Conventional echocardiography and tissue Doppler imaging were performed during initial hospital admission and 6 months after CRT implantation. The mitral inflow (E/A ratio, mitral valve deceleration time=E dec) was assessed with pulsed wave Doppler echocardiography (PWD). Mitral inflow color propagation (Vp) velocity was evaluated with color M mode and early diastolic mitral annular velocity (e') at the lateral and septal annulus were measured by TDI. Mitral E/e' and E/Vp were calculated in order to estimate LV filling pressures. Results: Compared to baseline, the E/A ratio (1.52±1.02 vs 1.19±0.86, p=0.01) decreased significantly and E deceleration time (150.38±42.91 ms vs 152.38±53.50 ms, p=0.02) increased significantly at the 6th month. Septal E/e' (19.19±12.67 vs 14.65±7.22, p=0.015), Lateral E/e' (13.86±8.67 vs 12.87±5.90, p=0.001), Average E/e' (15.16±7.55 vs 13.29±5.65, p=0.002) and E/Vp (2.44±1.01 vs 1.19±0.86, p= 0.042) ratio decreased significantly at 6th month after CRT. Conclusions: These results discloses the significant improvement of dias- tolic functions and LV filling pressures in patients who were treated with CRT devices.