414 Ventricular-arterial interaction predicts response to cardiac resynchronization therapy: a link with improvement of endothelial function and arterial elastic properties
| العنوان: | 414 Ventricular-arterial interaction predicts response to cardiac resynchronization therapy: a link with improvement of endothelial function and arterial elastic properties |
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| المؤلفون: | Antonios Sideris, Panagiotis Simitsis, John Parissis, Gerasimos Filippatos, M Efremidis, Dimitrios Manolatos, Nikolaos Karamichalakis, Ignatios Ikonomidis, Sotirios Xydonas, K Vlachos, K Letsas, Stamatis Georgopoulos |
| المصدر: | European Heart Journal - Cardiovascular Imaging. 21 |
| بيانات النشر: | Oxford University Press (OUP), 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | medicine.medical_specialty, business.industry, Internal medicine, medicine.medical_treatment, medicine, Cardiac resynchronization therapy, Cardiology, Radiology, Nuclear Medicine and imaging, General Medicine, Function (mathematics), Cardiology and Cardiovascular Medicine, business |
| الوصف: | Background Endothelial dysfunction (ED) is a hall mark of chronic heart failure and has been linked to disease progression, hospitalizations and mortality. Purpose to evaluate the impact of cardiac resynchronization therapy (CRT) in ED and to determine predictors of response to CRT Methods CRT recipients from 19/07/2016 until 19/10/2018 were studied at baseline and 3 months after. In each visit we evaluated a 12 lead ECG, carotid to femoral pulse wave velocity (cfPWV), flow-mediated dilatation of the brachial artery (FMD), left ventricle ejection fraction (LVEF) and left ventricle (LV) global longitudinal strain (GLS). We evaluated arterial elastance (Ea) to ventricular elastance (Ees) ratio (Ea/Ees) by echocardiography and the ratio of cfPWV to GLS, as valid markers of ventricular-arterial interaction. We also assessed the layer of endothelial glycocalyx by measurement of Perfused Boundary Region (PBR) of the sublingual microvessel range:5-25 microns. Results 32 patients with a mean age 65.5 (±10.9) years and severe LV systolic dysfunction were enrolled. During follow-up, LVEF, GLS, LVESV and all ED markers exhibited significant improvement (table 1). 23 patients were responders. Among the baseline vascular function markers, only the ratio cfPWV/GLS predicted response to CRT (OR: 0.245, 95%CI: 0.042-0.759, p = 0.044).Threshold analysis showed that the best threshold of cfPWV/GLS for response to CRT was 2.75 (specificity: 0.67%, sensitivity: 0.94%). Conclusions After 3 months of CRT, endothelial function, arterial elasticity and ventricular arterial interaction are improved. The baseline ratio cfPWV/GLS, a novel marker of ventricular arterial interaction, can be applied to predict response to CRT. table 1 Baseline Follow-up Change Measurement mean (sd) mean (sd) mean (sd) p-value SBP (mmHg) 126 (19) 128 (16) 2.18 (11.98) 0,465 DBP (mmHg) 79 (9) 80 (9) 1.06 (8.58) 0,618 LVEF (%) 27 (7) 35 (9) 7.50 (4.77) Abstract 414 Figure. picture 1 |
| تدمد: | 2047-2412 2047-2404 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::e6f7c11820b217ce6e895c33b5fd524c https://doi.org/10.1093/ehjci/jez319.228 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi...........e6f7c11820b217ce6e895c33b5fd524c |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20472412 20472404 |
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