European Heart Journal Advance Access first published online on April 13, 2006
This version published online on April 27, 2006
European Heart Journal, doi:10.1093/eurheartj/ehi885
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1 Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, S.H. Ho Cardiovascular and Stroke Centre, Institute of Vascular Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong
* To whom correspondence should be addressed. Aims LV reverse remodelling has been shown to be a favourable response after cardiac resynchronization therapy (CRT) in many clinical trials. This study investigated whether left ventricular (LV) reverse remodelling after CRT has any structural benefit, which include the improvement of LV mass or regional wall thickness. Methods and results Fifty patients (66 ± 11 years) receiving CRT were followed up for at least 3 months. Echocardiography with tissue Doppler imaging was performed serially before and at day 1 and 3 months after CRT. Although LV end-systolic volume (LVESV) was decreased at day 1 after CRT (141 ± 74 vs. 129 ± 71 cm3, P<0.001), further LV reverse remodelling was observed at 3 months (110 ± 67 cm3, P<0.001 vs. day 1). LV ejection fraction increased at day 1 (26.5 ± 9.3 vs. 28.5 ± 9.1%, P<0.005) and was further improved at 3 months (34.2 ± 10.5%, P<0.001 vs. day 1). However, reduction of LV mass (231 ± 67 vs. 213 ± 59 g, P<0.001) and regional wall thickness was only observed at 3 months, but not at day 1. The improvement of LV mass correlated with the change in LVESV (r=0.66, P<0.001) and the baseline systolic asynchrony index (Ts-SD) (r=-0.52, P<0.001). LV mass was only decreased significantly in responders of LV reverse remodelling (245 ± 66 vs. 207 ± 61 g, P<0.001), but increased in non-responders (209 ± 64 vs. 223 ± 56 g, P=0.02). Responders had significant decrease in thickness of all the four walls for -6 to -11% (all P Conclusion The acute reduction in LV volume after CRT is mediated by haemodynamic and geometric benefits without actual changes in LV mass. However, at 3-month follow-up, reduction in LV mass and regional wall thickness was demonstrated, which represents structural reverse remodelling. Such benefit was only observed in volumetric responders but was worsened in non-responders.
Received December 16, 2005
Revised March 14, 2006
Accepted March 23, 2006
Clinical research
Differential change in left ventricular mass and regional wall thickness after cardiac resynchronization therapy for heart failure
Qing Zhang 1,
Jeffery Wing-Hong Fung 1,
Angelo Auricchio 2,
Joseph Yat-Sun Chan 1,
Leo C.C. Kum 1,
Li Wen Wu 1,
and
Cheuk-Man Yu 1 *
2 Fondazione Cardiocentro Ticino, Via Tesserete 48, CH-6900 Lugano, Switzerland
Cheuk-Man Yu, E-mail: cmyu{at}cuhk.edu.hk
Abstract 
0.02), whereas non-responders had increased thickness in septal and lateral walls for +11% (both P<0.05).
The author name of Jeffrey Wing-Hong Fung and the affiliation for Angelo Auricchio in the originally published version of this paper were incorrect. The author apologizes that these errors were not identified earlier.
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