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Early and Late Effects of Cardiac Resynchronization Therapy in Adult Congenital Heart Disease

BACKGROUND: There are limited data about cardiac resynchronization therapy (CRT) in adult congenital heart disease. We aimed to assess early and late outcomes of CRT among patients with adult congenital heart disease. METHODS AND RESULTS: We retrospectively studied 54 patients with adult congenital...

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Autores principales: Yin, Yanrong, Dimopoulos, Konstantinos, Shimada, Eriko, Lascelles, Karen, Griffiths, Samuel, Wong, Tom, Gatzoulis, Michael A., Babu‐Narayan, Sonya V., Li, Wei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6898795/
https://www.ncbi.nlm.nih.gov/pubmed/31657270
http://dx.doi.org/10.1161/JAHA.119.012744
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author Yin, Yanrong
Dimopoulos, Konstantinos
Shimada, Eriko
Lascelles, Karen
Griffiths, Samuel
Wong, Tom
Gatzoulis, Michael A.
Babu‐Narayan, Sonya V.
Li, Wei
author_facet Yin, Yanrong
Dimopoulos, Konstantinos
Shimada, Eriko
Lascelles, Karen
Griffiths, Samuel
Wong, Tom
Gatzoulis, Michael A.
Babu‐Narayan, Sonya V.
Li, Wei
author_sort Yin, Yanrong
collection PubMed
description BACKGROUND: There are limited data about cardiac resynchronization therapy (CRT) in adult congenital heart disease. We aimed to assess early and late outcomes of CRT among patients with adult congenital heart disease. METHODS AND RESULTS: We retrospectively studied 54 patients with adult congenital heart disease (median age, 46 years; range, 18–73 years; 74% men) who received CRT implantation (biventricular paced >90%) between 2004 and 2017. Clinical and echocardiographic data were analyzed at baseline and early (mean±SD: 1.8±0.8 years) and late (4.7±0.8 years) follow‐up after CRT. Compared with baseline, CRT was associated with significant improvement at early follow‐up in New York Heart Association functional class, QRS duration, and cardiothoracic ratio (P<0.05 for all); improvement in New York Heart Association class was sustained at late follow‐up. Among patients with a systemic left ventricle (LV; n=39), there was significant increase in LV ejection fraction and reduction in LV end‐systolic volume at early and late follow‐up (P<0.05 for both). For patients with a systemic right ventricle (n=15), there was a significant early but not late reduction in systemic right ventricular basal and longitudinal diameters. Eleven patients died, and 2 had heart transplantation unrelated to systemic ventricular morphological characteristics. Thirty‐five patients (65%) responded positively to CRT, but only baseline QRS duration was predictive of a positive response. CONCLUSIONS: CRT results in sustained improvement in functional class, systemic LV size, and function. Patients with a systemic LV and prolonged QRS duration, independent of QRS morphological characteristics, were most likely to respond to CRT.
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spelling pubmed-68987952019-12-16 Early and Late Effects of Cardiac Resynchronization Therapy in Adult Congenital Heart Disease Yin, Yanrong Dimopoulos, Konstantinos Shimada, Eriko Lascelles, Karen Griffiths, Samuel Wong, Tom Gatzoulis, Michael A. Babu‐Narayan, Sonya V. Li, Wei J Am Heart Assoc Original Research BACKGROUND: There are limited data about cardiac resynchronization therapy (CRT) in adult congenital heart disease. We aimed to assess early and late outcomes of CRT among patients with adult congenital heart disease. METHODS AND RESULTS: We retrospectively studied 54 patients with adult congenital heart disease (median age, 46 years; range, 18–73 years; 74% men) who received CRT implantation (biventricular paced >90%) between 2004 and 2017. Clinical and echocardiographic data were analyzed at baseline and early (mean±SD: 1.8±0.8 years) and late (4.7±0.8 years) follow‐up after CRT. Compared with baseline, CRT was associated with significant improvement at early follow‐up in New York Heart Association functional class, QRS duration, and cardiothoracic ratio (P<0.05 for all); improvement in New York Heart Association class was sustained at late follow‐up. Among patients with a systemic left ventricle (LV; n=39), there was significant increase in LV ejection fraction and reduction in LV end‐systolic volume at early and late follow‐up (P<0.05 for both). For patients with a systemic right ventricle (n=15), there was a significant early but not late reduction in systemic right ventricular basal and longitudinal diameters. Eleven patients died, and 2 had heart transplantation unrelated to systemic ventricular morphological characteristics. Thirty‐five patients (65%) responded positively to CRT, but only baseline QRS duration was predictive of a positive response. CONCLUSIONS: CRT results in sustained improvement in functional class, systemic LV size, and function. Patients with a systemic LV and prolonged QRS duration, independent of QRS morphological characteristics, were most likely to respond to CRT. John Wiley and Sons Inc. 2019-10-28 /pmc/articles/PMC6898795/ /pubmed/31657270 http://dx.doi.org/10.1161/JAHA.119.012744 Text en © 2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Yin, Yanrong
Dimopoulos, Konstantinos
Shimada, Eriko
Lascelles, Karen
Griffiths, Samuel
Wong, Tom
Gatzoulis, Michael A.
Babu‐Narayan, Sonya V.
Li, Wei
Early and Late Effects of Cardiac Resynchronization Therapy in Adult Congenital Heart Disease
title Early and Late Effects of Cardiac Resynchronization Therapy in Adult Congenital Heart Disease
title_full Early and Late Effects of Cardiac Resynchronization Therapy in Adult Congenital Heart Disease
title_fullStr Early and Late Effects of Cardiac Resynchronization Therapy in Adult Congenital Heart Disease
title_full_unstemmed Early and Late Effects of Cardiac Resynchronization Therapy in Adult Congenital Heart Disease
title_short Early and Late Effects of Cardiac Resynchronization Therapy in Adult Congenital Heart Disease
title_sort early and late effects of cardiac resynchronization therapy in adult congenital heart disease
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6898795/
https://www.ncbi.nlm.nih.gov/pubmed/31657270
http://dx.doi.org/10.1161/JAHA.119.012744
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