Abstract 3379: Atrium Reverse Remodeling in patients with Cardiac Resynchronization Therapy
Background: Previous studies have shown the improvement of left ventricle (LV) function associated with reverse remodeling after cardiac resynchronization therapy (CRT). The aim of this study was to investigate the effect of CRT on atrial function.
Methods: One hundred and seven patients (66±11yrs) with advanced heart failure receiving CRT were followed up for 3 months. Echocardiography with tissue Doppler imaging (TDI) was performed serially before and 3 months after CRT. Atrial function was assessed by 2 dimensional echo, TDI, strain imaging and atrial emptying fraction based on the change in areas (LAA-EF) and volumes (LAV-EF). Patients were compared according to the LV volumetric response to CRT (defined as a reduction of LV end-systolic volume >10%).
Results: After CRT, LAA-EF-4ch, LAA-EF-3ch and LAV-EF were significantly increased (all p<0.001, Table⇓), and significantly improved in responders (N=64, all p<0.001) without change in non-responders (N=43, all p=NS). By TDI analysis, LA contraction velocity (VA) increase only appeared in responders. Furthermore, enhancement of strain in LA and RA in ventricular end-systole (εs) and early diastole (εe) was only observed in the responders.
Conclusion: CRT not only improves LV function, but also results in LA reverses remodeling with gain in atrial contractile function. Atrial compliance was also improved as suggested in the favorable changes in strain parameters.