The Effect of CRT Therapy on RV Function in Patients with Severe LV Dysfunction: A Matched Control Study

Abstract

Background: Whilst numerous studies have established the prognostic and symptomatic benefits of cardiac resynchronization therapy (CRT) on left ventricle (LV), its effect on right ventricular (RV) function has not been well described. Radionuclide ventriculography (RNV) is a well established technique for RV function assessment. We evaluated the effect of CRT on RV function using RNV in patients with severe LV dysfunction.

Methods: 76 patients who underwent CRT implantation and diagnostic pre and post CRT RNV were retrospectively identified. The control group (n=76) included patients who underwent implantable cardioverter defibrillator (ICD) implantation alone and were matched for age, gender, etiology of heart failure and LV function. Electrocardiographic gated equilibrium planar acquisitions (24 frames/RR interval) in the left anterior oblique projection (40-50º) were used for the analysis of RV function. RV ejection fraction, RV volumes and RV peak filling rate were calculated.

Results: Mean age (65 vs. 66 years), gender ratio (83% vs. 82% males), ischemic etiology (76% vs. 76%) and LV function (21% vs. 23%) were similar in the test and control groups respectively. Significant improvements in RV systolic (RV ejection fraction and end systolic volume) and diastolic (RV peak filling rate) parameters were observed only in the CRT group (Table 1).

Change in measures of right ventricular systolic and diastolic function in cohort followed with right ventriculography

ICD=implantable cardioverter defibrillator

Conclusions: In patients with LV dysfunction, CRT improves RV systolic and diastolic function. A multicenter study is needed to confirm these findings.

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