The Corelation Of Left Atrial Dimension And The Efficacy Of Cardiac Resynchronization Therapy In Patients With Chronic Heart Failure

ObjectiveTo explore the corelation of left atrial dimension and the efficacy of cardiac rsynchronization therapy pacemaker (CRT-P) or the device with defibrillator (CRT-D) in patients with chronic heart failure, including baseline LAD and percent reduction of LAD12months after devices implanted.Methods47patients implanted CRT-P/D successfully from Dec.2008to Apr.2013in the Second Xiangya Hospital of Central South University, all patients were evaluated at baseline and regular follow-ups (3,6,12months and annually after), including LAD, left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD), QRS duration, New York Heart Association (NYHA) classification, the Minnesota heart failure quality of life and end points events (heart failure readmission and death).All patients were stratified into quartiles based on baseline LAD and percent reduction of LAD after12months:②High and low baseline LAD groups:High baseline LAD group were those in the highest quartile of baseline LAD (baseline LAD>50mm) and low baseline LAD group were those in the lowest three quartiles of baseline LAD (baseline LAD<50mm).②High and low LAD responders:High LAD responders were those in the highest three quartiles of LAD reduction (LAD reduction≥5.4%) and low LAD responders were those in the lowest quartile of LAD reduction (LAD reduction<5.4%). We analyzed baseline characteristics, follow-ups and end points events in these groups.Results1. Baseline LAD:Reduction in LAD, LVEDD after6months of follow-ups (P<0.05), More reduction of LAD, LVEDD in12months of low baseline LAD patients, who also had less end points events than high baseline LAD patients (P<0.05).2. Percent reduction of LAD change after12months:Improvement of LVEDD, LVEF, NYHA classification, quality of life were significantly greater of high LAD responders, also who had had less end points events than low LAD responders (P<0.05).Conclusions1. CRT exerts pronounced reverse remodeling effects on left atrium and left ventricle in patients with chronic heart failure.2. Baseline LAD of CRT can help to predict the efficacy and assess the prognosis of CRT in patients with chronic heart failure.3. Percent reduction of LAD change after12months can help to assess the efficacy and prognosis of CRT in patients with chronic heart failure.