Endothelial dysfunction in heart failure identifies responders to cardiac resynchronization therapy.
BACKGROUND: The presence of endothelial dysfunction is associated with increased heart failure mortality. Cardiac resynchronization therapy (CRT) improves heart failure outcomes; however, current guidelines do not adequately identify responders to CRT.
OBJECTIVE: The purpose of this study was to determine whether endothelial dysfunction can predict response to CRT.
METHODS: Brachial artery flow-mediated dilation, a measure of endothelial function, was measured at baseline preimplant and 90 days postimplant in 33 patients undergoing CRT (age 64.2 +/- 16.8 years, left ventricular ejection fraction [LVEF] 25% +/- 9%, QRS duration 158 +/- 25 ms, New York Heart Association class III-IV).
RESULTS: Of the 33 patients, 19 (58%) were responders to CRT. Baseline flow-mediated dilation was 4.6% +/- 4.5% in responders and 8.6% +/- 4.2% in nonresponders (P
CONCLUSION: The presence of endothelial dysfunction independently identifies CRT responders and provides additive prognostic value for predicting response over current criteria. Addition of endothelial function assessment to current selection criteria may improve the ability to identify CRT responders.
Published In/Presented At
Akar, J. G., Al-Chekakie, M. O., Fugate, T., Moran, L., Froloshki, B., Varma, N., Santucci, P., Wilber, D. J., & Matsumura, M. E. (2008). Endothelial dysfunction in heart failure identifies responders to cardiac resynchronization therapy. Heart rhythm, 5(9), 1229–1235. https://doi.org/10.1016/j.hrthm.2008.05.027
Medicine and Health Sciences
Department of Medicine