Analysis of left ventricular function in patients with heart failure undergoing cardiac resynchronization

Abstract

Rev Bras Cir Cardiovasc 2013;28(1):69-75 Benfatti RA, et al. -Analysis of left ventricular function in patients with heart failure undergoing cardiac resynchronization RBCCV 44205-1444 DOI: 10.5935/1678 Analysis of left ventricular function in patients with heart failure undergoing cardiac resynchronization Objective: To analyze the left ventricular function by echocardiography in patients with advanced heart failure with interventricular dyssynchrony undergone implantation of cardiac resynchronizer.Methods: Between June 2006 and June 2012, 24 patients with average age of 61.5 ± 11 years were evaluated, carriers of advanced congestive heart failure functional class III and IV (NYHA), interventricular dyssynchrony and optimal drug therapy, and submitted implantation of cardiac resynchronizer and postoperative echocardiographically evaluated in six months.Results: There was significant improvement of the analyzed echocardiography parameters. The average left ventricular diastolic diameter decreased from 69.6 ± 9.8 mm to 66.8 ± 8.8 mm, systolic diameters from 58.6 ± 8.8 mm to 52.7 ± 8.8 mm, and ejection fraction, average of 31 ± 8% to 40 ± 7% with level of significance, respectively, of 0.019, 0.0004 and 0.0002, statistically significant with a significance level of 0.05.Conclusion: There was a significant improvement of left ventricular function analyzed by echocardiography at six months, in patients with advanced heart failure undergone implantation of cardiac resynchronizer.Descriptors: Heart failure. Cardiac resynchronization therapy. Echocardiography. Abbreviations, acronyms & symbols INTRODUCTIONHeart failure (HF) one of the greatest clinical challenges in the current public health, and it is considered an epidemic on progress, diagnosed in 1% to 2% of developed countries population [1,2].The HF is one of the most prevalent causes of hospital admissions in Brazil, on the Unified Health System (SUS). In 2007, there were 1.156.136 hospital admissions for cardiovascular diseases, representing the third leading cause of hospital admissions on the SUS, and HF is the main one [3].The HF treatment has the purpose of symptoms improvement, reduction of mortality, hospital costs decreasing and prevention of readmissions. The treatment of heart failure consists of: nonpharmacological steps (diet, exercising, stress management, and others), drug therapy and surgery [3].Studies show that medical treatment should always include a beta blocker and an inhibitor of the angiotensin converting enzyme (ACE), composing the optimized medical treatment. For symptomatic patients, diuretics and digitalis are added. But if there is a disabling symptoms persistence, it is necessary to introduce aldosterone antagonists (functional class III heart failure by Criteria Committee of the New York Heart Association -NYHA) with strict control of serum potassium and combination of hydralazine + nitrate [3][4][5][6].The search for alternative or complementary methods to drug treatment, which could change the course of the disease, is a major ...

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