Effects of left ventricular geometry and postoperative blood pressure changes on efficacy of cardiac resynchronization therapy

AIM:To study the effects of left ventricular (LV) geometry and postoperative systolic blood pressure (SBP) changes on the efficacy of cardiac resynchronization therapy (CRT). METHODS: Twenty-one CRT recipients were included in the study. Before CRT and 6 months after, clinical and echocardigraphic evaluations were performed. At 6 months after CRT, the patients with a decrease of NYHA≥1 and a decrease of LVESV ≥10% were classified as CRT-responders and the others were classified as CRT-nonresponders. RESULTS: At baseline, no significant difference was observed in all patients except that CRT-responders had smaller LVEDD and better renal function. At 6 months after CRT, LVEF increased ［(32±9)% vs. (45±10)%, P<0.05］, whereas NYHA (6/8, III/IV vs. 11/3, II/III), LVEDD ［(68±8)mm vs.(55±6)mm, P<0.05］, LVEDV ［(237±54)ml vs.(151±45)ml, P<0.05］ and LVESV ［(165±46) ml vs. (84±31), P=0.01］ decreased in CRT-responders. No significant improvement was observed in CRT-nonresponders. A marked increase of SBP was found in CRT-responders. CONCLUSION: Less-altered ventricular geometry, smaller LVEDD and a prompt SBP rise just after CRT may predict a better response in CRT recipients.