Improvement in Right Ventricular Systolic Function after Cardiac Resynchronization Therapy Correlates with Left Ventricular Reverse Remodeling

Objective: We aimed to determine echocardiographic correlates of improvement in RV systolic function after CRT. Methods: Fifty-four patients (61.9 +/- 10.5 years; 43 men; LV ejection fraction 24.6 +/- 4.0%; QRS duration > 120 ms) with HF were enrolled. Standard echocardiography, strain rate (SR), and tissue Doppler imaging were performed in all patients before and 6 months after CRT. Pulsed-wave TDI-derived systolic indices of RV included systolic (RVS) and isovolumic velocity (RVIVV) and isovolumic acceleration (RVIVA). Response to CRT was defined as decline in LV end-systolic volume (LVESV) >= 10%. Results: When indices of RV systolic function were assessed between responders and nonresponders, in responders (38 patients, 70.4%) RV end-diastolic diameters (RVD1-3), mid-RV strain, and mid-RV SR improved significantly (P < 0.01, for all). RVS (10.77 +/- 4.29 vs 12.62 +/- 4.10 cm/sec, P = 0.005), RVIVV (14.71 +/- 5.88 vs 18.52 +/- 6.62 cm/sec, P < 0.001), and RVIVA (1.69 +/- 0.70 vs 2.39 +/- 0.77 m/sec2, P < 0.001) significantly increased among responders. There was no significant change in these parameters among nonresponders. Pearson's analyses revealed moderate positive correlations between reduction of LVESV and delta RVIVV (r = 0.467, P = 0.001) and delta RVIVA (r = 0.473, P = 0.001), respectively. Conclusions: RV diameters and systolic indices after CRT improved only in the responder group. Improvement in RV systolic performance after CRT is correlated with the reduction of LVESV. (PACE 2011; 34:200-207).