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European Journal of Heart Failure 2009 11(7):706-708; doi:10.1093/eurjhf/hfp069
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

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

Gerjan de Roest1,2,*, Paul Knaapen1,2, Marco Götte1,2, Thijs Hendriks1,2, Cor Allaart1,2, Carel de Cock1,2 and Albert van Rossum1,2

1 Department of Cardiology, VU University Medical Center, De Boelelaan 1118, 1081 HV Amsterdam, The Netherlands
2 Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center, Amsterdam, The Netherlands

* Corresponding author: Tel: +31 20 444 3847, Fax: +31 20 444 2446, Email: gj.deroest{at}vumc.nl


  Abstract

Background: Cardiac 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.

Methods: Thirty-four CRT candidates were haemodynamically evaluated by pressure–volume loop analysis during biventricular pacing.

Results: Mean 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.

Conclusion: Although both parameters display an average increase during pacing, the change relative to baseline values of SW and dP/dtmax is not related.

Key Words: Cardiac resynchronization therapy • Acute haemodynamic response • Invasive measurements

Received November 28, 2008; Revised April 27, 2009; Accepted April 27, 2009


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