Publication
Benefícios da Terapêutica de Ressincronização Cardíaca na «Miocardiopatia Muito Dilatada»
| dc.contributor.author | Lousinha, A | |
| dc.contributor.author | Oliveira, MM | |
| dc.contributor.author | Feliciano, J | |
| dc.contributor.author | Galrinho, A | |
| dc.contributor.author | Branco, LM | |
| dc.contributor.author | Silva Cunha, P | |
| dc.contributor.author | Hamad, H | |
| dc.contributor.author | Ramos, R | |
| dc.contributor.author | Abreu, J | |
| dc.contributor.author | Leal, A | |
| dc.contributor.author | Santos, S | |
| dc.contributor.author | Soares, RM | |
| dc.contributor.author | Nogueira da Silva, M | |
| dc.contributor.author | Cruz Ferreira, R | |
| dc.date.accessioned | 2011-10-18T15:38:51Z | |
| dc.date.available | 2011-10-18T15:38:51Z | |
| dc.date.issued | 2011 | |
| dc.description.abstract | INTRODUCTION: Recent clinical trials have studied parameters that could predict response to cardiac resynchronization therapy (CRT) in patients with advanced heart failure. Left ventricular end-diastolic dimension (LVEDD) is regarded as a possible predictor of response to CRT. OBJECTIVE: To study the response to CRT in patients with very dilated cardiomyopathy, i.e. those at a more advanced stage of the pathology, analyzing both the responder rate and reverse remodeling in two groups of patients classified according to LVEDD. METHODS: We performed a retrospective analysis of 71 patients who underwent CRT (aged 62 +/- 11 years; 65% male; 93% in NYHA functional class > or = III; 31% with ischemic cardiomyopathy; left ventricular ejection fraction [LVEF] 25.6 +/- 6.8%; 32% in atrial fibrillation; QRS 176 +/- 31 ms). Twenty-two (31%) patients with LVEDD > or = 45 mm/m2 (49.2 +/- 3.5 mm/m2) were considered to have very dilated cardiomyopathy (Group A) and 49 patients had LVEDD > 37 mm/m2 and < 45 mm/m2 (39.4 +/- 3.8 mm/m2) (Group B). All patients were assessed by two-dimensional echocardiography at baseline and six months after CRT. The following parameters were analyzed: NYHA functional class, LVEF and LVEDD. Responders were defined clinically (improvement of > or = 1 NYHA class) and by echocardiography, with a minimum 15% increase over baseline LVEF combined with a reduction in LVEDD (reverse remodeling). RESULTS: There were no significant differences in baseline demographic characteristics between the two groups. At six-month followup, we observed an improvement in LVEF (delta 8.5 +/- 11.8%) and a reduction in LVEDD (delta 3.7 +/- 6.8 mm/m2), with fifty-seven (79%) patients being classified as clinical responders. The percentage of patients with reverse remodeling was similar in both groups (64% vs. 73%, p = NS), as were percentages of improved LVEF (delta 6.3 +/- 11% vs. delta 9.6 +/- 12%; p = NS) and decreased LVEDD (delta 3.7 +/- 5.5 mm/m2 vs. delta 3.7 +/- 7.4 mm/m2; p = NS). We found a higher percentage of clinical responders in patients with very dilated cardiomyopathy (96% vs. 72%, p < 0.05). CONCLUSION: In this study, a significant number of responders showed reverse remodeling after CRT. Although a higher percentage of patients with very dilated cardiomyopathy showed improvement in functional class, the extent of reverse remodeling was similar in both groups. | por |
| dc.identifier.citation | Rev Port Cardiol. 2011 Mar;30(3):283-94 | por |
| dc.identifier.uri | http://hdl.handle.net/10400.17/401 | |
| dc.language.iso | por | por |
| dc.peerreviewed | yes | por |
| dc.publisher | Sociedade Portuguesa de Cardiologia | por |
| dc.subject | Terapêutica de Ressincronização Cardíaca | por |
| dc.subject | Cardiomiopatia Dilatada | por |
| dc.subject | Estudos de Follow-Up | por |
| dc.subject | Estudos Retrospectivos | por |
| dc.subject | Índice de Gravidade da Doença | por |
| dc.subject | HSM CAR | |
| dc.title | Benefícios da Terapêutica de Ressincronização Cardíaca na «Miocardiopatia Muito Dilatada» | por |
| dc.title.alternative | Benefits of Cardiac Resynchronization Therapy in "Very Dilated Cardiomyopathy" | por |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.endPage | 294 | por |
| oaire.citation.startPage | 283 | por |
| oaire.citation.title | Revista Portuguesa de Cardiologia | por |
| rcaap.rights | openAccess | por |
| rcaap.type | article | por |