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J Am Coll Cardiol, 2007; 50:778-785, doi:10.1016/j.jacc.2007.04.073 (Published online 6 August 2007).
© 2007 by the American College of Cardiology Foundation
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Improvement of Atrial Function and Atrial Reverse Remodeling After Cardiac Resynchronization Therapy for Heart Failure

Cheuk-Man Yu, MD, FRCP, FRACP*,*, Fang Fang, MM, PhD{dagger}, Qing Zhang, MM, PhD*, Gabriel W.K. Yip, MD*, Chun Mei Li, BM*, Joseph Yat-Sun Chan, FHKAM*, LiWen Wu, BM* and Jeffrey Wing-Hong Fung, FRCP*

* Li Ka Shing Institute of Health Sciences, Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital and Institute of Vascular Medicine, S.H. Ho Cardiovascular and Stroke Centre, Shatin, N.T., Hong Kong, China
{dagger} Ultrasound Department, Beijing AnZhen Hospital, Capital Medical University, Beijing, China.


Figure 1
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  		Figure 1 Apical 4-Chamber View Showing the Changes of Left Atrial Size After CRT

In a responder of left ventricular reverse remodeling, the LA size after atrial contraction was significantly reduced when compared between baseline (A) and 3-month follow-up (B), in contrast to a nonresponder in whom the LA size remained unchanged between baseline (C) and 3-month follow-up (D). CRT = cardiac resynchronization therapy.

 

Figure 2
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  		Figure 2 Assessment of Regional Left Atrial Velocity by Tissue Doppler Imaging at Apical 4-Chamber View

The sampling window was placed at the midatrial level. In a responder of left ventricular reverse remodeling, there was improvement of atrial contraction velocity (arrows) when compared between baseline (A) and 3 months after cardiac resynchronization therapy (B). On the other hand, the nonresponder showed no improvement of atrial contraction velocity (arrows) between baseline (C) and 3-month follow-up (D).

 

Figure 3
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  		Figure 3 Assessment of Atrial Strain at Mid Level of Left Atria in the Same Patients as in Figure 2

In a responder of left ventricular reverse remodeling, left atrial strain at ventricular end-systole ({varepsilon}s), early diastole ({varepsilon}e) as well as after atrial contraction ({varepsilon}a) was increased when compared with baseline (A) and 3 months after cardiac resynchronization therapy (B). On the other hand, the nonresponder showed no improvement of atrial strain between baseline (C) and 3-month follow-up (D).

 




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Copyright © 2007 by the American College of Cardiology Foundation.