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30.06.2017 | Original Article

Effects of cardiac resynchronization therapy on right ventricular function during rest and exercise, as assessed by radionuclide angiography, and on NT-proBNP levels

Zeitschrift:
Journal of Nuclear Cardiology
Autoren:
MD, PhD Cinzia Valzania, MD Mauro Biffi, MD Rachele Bonfiglioli, MD Francesco Fallani, MD, PhD Cristian Martignani, MD, PhD Igor Diemberger, MD, PhD Matteo Ziacchi, BS Jessica Frisoni, BS Luciana Tomasi, MD Stefano Fanti, MD Claudio Rapezzi, MD, PhD Giuseppe Boriani
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s12350-017-0971-3) contains supplementary material, which is available to authorized users.
The authors of this article have provided a PowerPoint file, available for download at SpringerLink, which summarizes the contents of the paper and is free for re-use at meetings and presentations. Search for the article DOI on SpringerLink.​com.”

Abstract

Aim

We carried out this study to investigate mid-term effects of cardiac resynchronization therapy (CRT) on right ventricular (RV) function and neurohormonal response, expressed by N-terminal pro-brain natriuretic peptide (NT-proBNP), in heart failure patients stratified by baseline RV ejection fraction (RVEF).

Methods and Results

Thirty-six patients with nonischemic dilated cardiomyopathy underwent technetium-99m radionuclide angiography with bicycle exercise immediately after CRT implantation (during spontaneous rhythm and after CRT activation) and 3 months later. Plasma NT proBNP was assessed before implantation and after 3 months. At baseline, RVEF was impaired (≤35%) in 14 patients, preserved (>35%) in 22. At 3 months, RVEF improved during rest and exercise (P = .02) in patients with impaired RV function, while remaining unchanged in patients with preserved RV function. Rest and exercise RV dyssynchrony decreased in both groups at follow-up (P < .05). A similar mid-term improvement in left ventricular (LV) function and NT-proBNP was observed in patients with impaired and preserved RVEF. In the former, the decrease in NT-proBNP correlated with the improvements both in LV and RV dyssynchrony and functions.

Conclusion

CRT may improve RV performance, during rest and exercise, and neurohormonal response in heart failure patients with nonischemic dilated cardiomyopathy and baseline RV dysfunction. RV dysfunction should not be considered per se a primary criterion for excluding candidacy to CRT.

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Zusatzmaterial
Supplementary material 1 (PPTX 4357 kb)
12350_2017_971_MOESM1_ESM.pptx
Literatur
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