Abstract 3402: Improvement of Left Ventricular Regional Function and Reverse Remodeling in Heart Failure Patients Received Cardiac Contractility Modulation Therapy-A Comprehensive Assessment by Real-Time 3D Echocardiogram and Tissue Doppler Imaging
Introduction: Cardiac Contractility Modulation (CCM) is a new form of device based therapy for advance heart failure patient even with normal QRS width and therefore not a candidate for cardiac resynchronization therapy. Previous studies showed that CCM improved left ventricular (LV) ejection fraction (EF) and clinical parameters of heart failure patients. However data from comprehensive echocardiographic assessment and structural reverse remodeling is lacking.
Methods: 18 patients (mean age: 56±9 years, 15 males) with NYHA class III heart failure, QRS <120msec and already on optimal medical therapy received CCM. Real-time 3D echocardiography (RT3DE) (IE33, Philips) and tissue Doppler imaging (TDI) (Vivid 7, GE) were performed at baseline and 3 months after CCM.
Results: LV reverse remodeling with reduction in volumes and gain in EF was observed by RT3DE at 3 months. TDI also showed improvement of regional systolic function resulting in an increase in peak systolic velocity by measuring 12 (Mean Sm-12) or 6 basal (Mean Sm-6) LV segments. LV filling pressure estimated by E/E’ was also favorably reduced (Table⇓).
Conclusions: CCM improves both global and regional LV contractility and reduces filling pressure leading to LV reverse remodeling.