Stroke work or systolic dP/dtmax to evaluate acute response to cardiac resynchronization therapy: are they interchangeable?


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Abstract

BackgroundCardiac resynchronization therapy (CRT) is characterized by a ∼30% non-response. Invasive haemodynamic measurements are a traditional method to evaluate response to CRT. This study evaluates the correlation between acute changes in dP/dtmax and Stroke Work (SW) during CRT.MethodsThirty-four CRT candidates were haemodynamically evaluated by pressure–volume loop analysis during biventricular pacing.ResultsMean dP/dtmax and SW at baseline were 854 ± 198 and 5186 ± 2349, and displayed an increase during pacing of 106 ± 117 mmHg/s (13% ± 14%) and 1303 ± 3039 mL/mmHg (30% ± 52%), respectively. No correlation was found between the percentage change in dP/dtmax and SW (R=0.06, P=ns). When defining response an augmentation of 10% relative to baseline for both parameters, 16 patients demonstrated an ambiguous response.ConclusionAlthough both parameters display an average increase during pacing, the change relative to baseline values of SW and dP/dtmax is not related.

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