The Reverse Of Left Ventricular Remodeling After Cardiac Resynchronization Therapy On Congestive Heart Faliure

Object:To investigate the mechanical remodeling after cardiac resynchronization therapy in chronic congestive heart failure patients and compare different outcome of cardiac resynchronization therapy in ischemic cardiomyopathy and dilated cardiomyopathy.Method:21 congestive heart failure patients were selected. There are 13 dilated cardiomyopathy patients and 8 ischemic cardiomyopathy patients who are all in accordance with guidelines for class I indication.The left ventricular ejection fraction, left atrium diameter,left ventricular endsystole, left ventricular diastolic diameter, left ventricular end systolic volume, left ventricular end diastolic volume, mitral regurgitation were observed.Results:(1) The LVEF was increased at 1-6 and 6-12 month follow-up (P<0.05); LVDS, LVESV and left atrium diameter were reduced; LVDD and LVEDV were reduced at 1-6 month follow-up (P<0.05).(2) Mitral regurgitation was reduced at 6-12 month follow-up (P<0.05).(3) In dilated cardiomyopathy patients,LVEF was increased and LVDS, LVDD, LVEDV, LVESV, mitral regurgitation were reduced at 1-6 month follow-up (P<0.05); LVEF was increased and LVDS,LVDD,LVEDV,LVESV, left atrium diameter were reduced at 6-12 month follow-up (P<0.05); In ischemic cardiomyopathy group, LVEF was increased at 6-12 month follow-up (P<0.05); LVDD, mitral regurgitation and EF in dilated cardiomyopathy group changed more than that of ischemic cardiomyopathy group at 1-6 month follow-up (P<0.05);LVDS,LVEDV and LVESV in dilated cardiomyopathy group changed more than that of ischemic cardiomyopathy group at 6-12 month follow-up (P<0.05).Conclusion:1.CRT can reverse remodeling in 1 year and increase LVEF significantly.2.CRT reduce mitral regurgitation via reversing remodeling.3.Dilated cardiomyopathy patients achieve greater clinical outcome than Ischemic cardiomyopathy patients after CRT.