Abstract
Background: Cardiac resynchronization therapy (CRT) is an accepted intervention for chronic heart failure (HF), although approximately 30% of patients are non-responders. The purpose of this study was to determine whether exercise respiratory gas exchange obtained before CRT implantation predicts early response to CRT. Methods: Before CRT implantation, patients were assigned to either a mild-moderate group (Mod G, n = 33, age 67 ± 10 years) or a moderate-severe group (Sev G, n = 31, age 67 ± 10 years), based on abnormalities in exercise gas exchange. Severity of impaired gas exchange was based on a score from the measures of VE/VCO<inf>2</inf> slope, resting PETCO<inf>2</inf> and change of PETCO<inf>2</inf> from resting to peak. All measurements were performed before and 3 to 4 months after CRT implantation. Results: Although Mod G did not have improved gas exchange (p > 0.05), Sev G improved significantly (p < 0.05) post-CRT. In addition, Mod G did not show improved right ventricular systolic pressure (RSVP; pre vs post: 37 ± 14 vs 36 ± 11 mm Hg, p > 0.05), yet Sev G showed significantly improved RVSP, by 23% (50 ± 14 vs 42 ± 12 mm Hg, p < 0.05). Both groups had improved left ventricular ejection fraction (p < 0.05), New York Heart Association class (p < 0.05) and quality of life (p < 0.05), but no significant differences were observed between groups (p > 0.05). No significant changes were observed in brain natriuretic peptide in either group post-CRT. Conclusion: Based on pre-CRT implantation ventilatory gas exchange, subjects with the most impaired values appeared to have more improvement post-CRT, possibly associated with a decrease in RVSP.
| Original language | English (US) |
|---|---|
| Journal | Journal of Heart and Lung Transplantation |
| DOIs | |
| State | Accepted/In press - 2015 |
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Keywords
- Exercise
- Heart failure
- Pulmonary hypertension
- Right ventricle pressure
- Ventilatory efficiency
ASJC Scopus subject areas
- Transplantation
- Cardiology and Cardiovascular Medicine
- Pulmonary and Respiratory Medicine
- Surgery
Cite this
Ventilatory gas exchange and early response to cardiac resynchronization therapy. / Kim, Chul Ho; Olson, Lyle J.; Shen, Win K.; Cha, Yong-Mei; Johnson, Bruce David.
In: Journal of Heart and Lung Transplantation, 2015.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Ventilatory gas exchange and early response to cardiac resynchronization therapy
AU - Kim, Chul Ho
AU - Olson, Lyle J.
AU - Shen, Win K.
AU - Cha, Yong-Mei
AU - Johnson, Bruce David
PY - 2015
Y1 - 2015
N2 - Background: Cardiac resynchronization therapy (CRT) is an accepted intervention for chronic heart failure (HF), although approximately 30% of patients are non-responders. The purpose of this study was to determine whether exercise respiratory gas exchange obtained before CRT implantation predicts early response to CRT. Methods: Before CRT implantation, patients were assigned to either a mild-moderate group (Mod G, n = 33, age 67 ± 10 years) or a moderate-severe group (Sev G, n = 31, age 67 ± 10 years), based on abnormalities in exercise gas exchange. Severity of impaired gas exchange was based on a score from the measures of VE/VCO2 slope, resting PETCO2 and change of PETCO2 from resting to peak. All measurements were performed before and 3 to 4 months after CRT implantation. Results: Although Mod G did not have improved gas exchange (p > 0.05), Sev G improved significantly (p < 0.05) post-CRT. In addition, Mod G did not show improved right ventricular systolic pressure (RSVP; pre vs post: 37 ± 14 vs 36 ± 11 mm Hg, p > 0.05), yet Sev G showed significantly improved RVSP, by 23% (50 ± 14 vs 42 ± 12 mm Hg, p < 0.05). Both groups had improved left ventricular ejection fraction (p < 0.05), New York Heart Association class (p < 0.05) and quality of life (p < 0.05), but no significant differences were observed between groups (p > 0.05). No significant changes were observed in brain natriuretic peptide in either group post-CRT. Conclusion: Based on pre-CRT implantation ventilatory gas exchange, subjects with the most impaired values appeared to have more improvement post-CRT, possibly associated with a decrease in RVSP.
AB - Background: Cardiac resynchronization therapy (CRT) is an accepted intervention for chronic heart failure (HF), although approximately 30% of patients are non-responders. The purpose of this study was to determine whether exercise respiratory gas exchange obtained before CRT implantation predicts early response to CRT. Methods: Before CRT implantation, patients were assigned to either a mild-moderate group (Mod G, n = 33, age 67 ± 10 years) or a moderate-severe group (Sev G, n = 31, age 67 ± 10 years), based on abnormalities in exercise gas exchange. Severity of impaired gas exchange was based on a score from the measures of VE/VCO2 slope, resting PETCO2 and change of PETCO2 from resting to peak. All measurements were performed before and 3 to 4 months after CRT implantation. Results: Although Mod G did not have improved gas exchange (p > 0.05), Sev G improved significantly (p < 0.05) post-CRT. In addition, Mod G did not show improved right ventricular systolic pressure (RSVP; pre vs post: 37 ± 14 vs 36 ± 11 mm Hg, p > 0.05), yet Sev G showed significantly improved RVSP, by 23% (50 ± 14 vs 42 ± 12 mm Hg, p < 0.05). Both groups had improved left ventricular ejection fraction (p < 0.05), New York Heart Association class (p < 0.05) and quality of life (p < 0.05), but no significant differences were observed between groups (p > 0.05). No significant changes were observed in brain natriuretic peptide in either group post-CRT. Conclusion: Based on pre-CRT implantation ventilatory gas exchange, subjects with the most impaired values appeared to have more improvement post-CRT, possibly associated with a decrease in RVSP.
KW - Exercise
KW - Heart failure
KW - Pulmonary hypertension
KW - Right ventricle pressure
KW - Ventilatory efficiency
UR - http://www.scopus.com/inward/record.url?scp=84936094154&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84936094154&partnerID=8YFLogxK
U2 - 10.1016/j.healun.2015.05.016
DO - 10.1016/j.healun.2015.05.016
M3 - Article
C2 - 26163155
AN - SCOPUS:84946482834
JO - Journal of Heart and Lung Transplantation
JF - Journal of Heart and Lung Transplantation
SN - 1053-2498
ER -