The "Missing" Link Between Acute Hemodynamic Effect and Clinical Response

Frits W. Prinzen*, Angelo Auricchio

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

19 Citations (Web of Science)

Abstract

The hemodynamic, mechanical and electrical effects of cardiac resynchronization therapy (CRT) occur immediate and are lasting as long as CRT is delivered. Therefore, it is reasonable to assume that acute hemodynamic effects should predict long-term outcome. However, in the literature there is more evidence against than in favour of this idea. This raises the question of what factor(s) do relate to the benefit of CRT. There is increasing evidence that dyssynchrony, presumably through the resultant abnormal local mechanical behaviour, induces extensive remodelling, comprising structure, as well as electrophysiological and contractile processes. Resynchronization has been shown to reverse these processes, even in cases of limited hemodynamic improvement. These data may indicate the need for a paradigm shift in order to achieve maximal long-term CRT response.
Original languageEnglish
Pages (from-to)188-195
JournalJournal of Cardiovascular Translational Research
Volume5
Issue number2
DOIs
Publication statusPublished - Apr 2012

Keywords

  • Cardiac resynchronization therapy
  • Hemodynamics
  • Remodeling

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