Effect of cardiac resynchronization therapy on right ventricular function

Kofo O. Ogunyankin, Jyothy John Puthumana

Research output: Contribution to journalReview articlepeer-review

10 Scopus citations

Abstract

PURPOSE OF REVIEW: The focus only on the left ventricle (LV) for both evaluation of cardiac dyssynchrony and the efficacy of resynchronization therapy (CRT) is too limited to explain the nuances of clinical response to CRT. Right ventricular function, synchrony and remodeling are now commonly characterized noninvasively. This review presents new insights into the role of the right ventricle independently and in conjunction with the LV in determining the clinical efficacy of CRT. RECENT FINDINGS: There are patients with predominantly right ventricular dyssynchrony who respond to CRT without reverse remodeling of the LV. Studies of longitudinal axis function of the right ventricle show that contractile function improvement precedes right ventricular reverse remodeling in clinical responders to CRT. The discordance seen in some CRT responders between improvements in left ventricular and right ventricular morphology, function and markers of synchrony is best understood using multiple markers of cardiac longitudinal axis function and cardiac deformation analysis. SUMMARY: Advanced right ventricular dysfunction reduces the likelihood of clinical response to CRT. However, right ventricular contractile function may improve following CRT independent of changes in right ventricular size or volumetric measures of right ventricular function. The consequences of isolated improvements in right ventricular function on CRT-related prognosis deserve further study.

Original languageEnglish (US)
Pages (from-to)464-468
Number of pages5
JournalCurrent Opinion in Cardiology
Volume25
Issue number5
DOIs
StatePublished - Sep 1 2010

Keywords

  • cardiac resynchronization therapy
  • right ventricular dyssynchrony
  • right ventricular strain

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

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