Relationship between reverse remodeling and cardiopulmonary exercise capacity in heart failure patients undergoing cardiac resynchronization therapy

M.H. Mastenbroek, Jetske Van't Sant, H. Versteeg, Maarten J Cramer, Pieter A Doevendans, Susanne S Pedersen, Mathias Meine

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background: 

Studies on the relationship between left ventricular reverse remodeling and cardiopulmonary exercise capacity in heart failure patients undergoing cardiac resynchronization therapy (CRT) are scarce and inconclusive.

Methods and results: 

Eighty-four patients with a 1st-time CRT-defibrillator (mean age 65 ± 11; 73% male) underwent echocardiography and cardiopulmonary exercise testing (CPX) before implantation (baseline) and 6 months after implantation. At baseline, patients also completed a set of questionnaires measuring mental and physical health. The association between echocardiographic response (left ventricular end-systolic volume decrease ≥15%) and a comprehensive set of CPX results was examined. Echocardiographic responders (54%) demonstrated higher peak oxygen consumption and better exercise performance than nonresponders at baseline and at 6-month follow-up. Furthermore, only echocardiographic responders showed improvements in ventilatory efficiency during follow-up. Multivariable repeated measures analyses revealed that, besides reverse remodeling, New York Heart Association functional class II and good patient-reported health status before implantation were the most important correlates of higher average oxygen consumption during exercise, and that nonischemic etiology and smaller pre-implantation QRS width were associated with better ventilatory efficiency over time.

Conclusions: 

During the first 6 months of CRT there was a significant positive association between reverse remodeling and cardiopulmonary exercise capacity.

Original languageEnglish
Pages (from-to)385–394
JournalJournal of Cardiac Failure
Volume22
Issue number5
DOIs
Publication statusPublished - 2016

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Exercise
Oxygen Consumption
Ventricular Remodeling
Echocardiography
Mental Health

Cite this

Mastenbroek, M.H. ; Sant, Jetske Van't ; Versteeg, H. ; Cramer, Maarten J ; Doevendans, Pieter A ; Pedersen, Susanne S ; Meine, Mathias. / Relationship between reverse remodeling and cardiopulmonary exercise capacity in heart failure patients undergoing cardiac resynchronization therapy. In: Journal of Cardiac Failure. 2016 ; Vol. 22, No. 5. pp. 385–394.
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title = "Relationship between reverse remodeling and cardiopulmonary exercise capacity in heart failure patients undergoing cardiac resynchronization therapy",
abstract = "Background: Studies on the relationship between left ventricular reverse remodeling and cardiopulmonary exercise capacity in heart failure patients undergoing cardiac resynchronization therapy (CRT) are scarce and inconclusive.Methods and results: Eighty-four patients with a 1st-time CRT-defibrillator (mean age 65 ± 11; 73{\%} male) underwent echocardiography and cardiopulmonary exercise testing (CPX) before implantation (baseline) and 6 months after implantation. At baseline, patients also completed a set of questionnaires measuring mental and physical health. The association between echocardiographic response (left ventricular end-systolic volume decrease ≥15{\%}) and a comprehensive set of CPX results was examined. Echocardiographic responders (54{\%}) demonstrated higher peak oxygen consumption and better exercise performance than nonresponders at baseline and at 6-month follow-up. Furthermore, only echocardiographic responders showed improvements in ventilatory efficiency during follow-up. Multivariable repeated measures analyses revealed that, besides reverse remodeling, New York Heart Association functional class II and good patient-reported health status before implantation were the most important correlates of higher average oxygen consumption during exercise, and that nonischemic etiology and smaller pre-implantation QRS width were associated with better ventilatory efficiency over time.Conclusions: During the first 6 months of CRT there was a significant positive association between reverse remodeling and cardiopulmonary exercise capacity.",
author = "M.H. Mastenbroek and Sant, {Jetske Van't} and H. Versteeg and Cramer, {Maarten J} and Doevendans, {Pieter A} and Pedersen, {Susanne S} and Mathias Meine",
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Relationship between reverse remodeling and cardiopulmonary exercise capacity in heart failure patients undergoing cardiac resynchronization therapy. / Mastenbroek, M.H.; Sant, Jetske Van't; Versteeg, H.; Cramer, Maarten J; Doevendans, Pieter A; Pedersen, Susanne S; Meine, Mathias.

In: Journal of Cardiac Failure, Vol. 22, No. 5, 2016, p. 385–394.

Research output: Contribution to journalArticleScientificpeer-review

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T1 - Relationship between reverse remodeling and cardiopulmonary exercise capacity in heart failure patients undergoing cardiac resynchronization therapy

AU - Mastenbroek, M.H.

AU - Sant, Jetske Van't

AU - Versteeg, H.

AU - Cramer, Maarten J

AU - Doevendans, Pieter A

AU - Pedersen, Susanne S

AU - Meine, Mathias

N1 - Copyright © 2015 Elsevier Inc. All rights reserved.

PY - 2016

Y1 - 2016

N2 - Background: Studies on the relationship between left ventricular reverse remodeling and cardiopulmonary exercise capacity in heart failure patients undergoing cardiac resynchronization therapy (CRT) are scarce and inconclusive.Methods and results: Eighty-four patients with a 1st-time CRT-defibrillator (mean age 65 ± 11; 73% male) underwent echocardiography and cardiopulmonary exercise testing (CPX) before implantation (baseline) and 6 months after implantation. At baseline, patients also completed a set of questionnaires measuring mental and physical health. The association between echocardiographic response (left ventricular end-systolic volume decrease ≥15%) and a comprehensive set of CPX results was examined. Echocardiographic responders (54%) demonstrated higher peak oxygen consumption and better exercise performance than nonresponders at baseline and at 6-month follow-up. Furthermore, only echocardiographic responders showed improvements in ventilatory efficiency during follow-up. Multivariable repeated measures analyses revealed that, besides reverse remodeling, New York Heart Association functional class II and good patient-reported health status before implantation were the most important correlates of higher average oxygen consumption during exercise, and that nonischemic etiology and smaller pre-implantation QRS width were associated with better ventilatory efficiency over time.Conclusions: During the first 6 months of CRT there was a significant positive association between reverse remodeling and cardiopulmonary exercise capacity.

AB - Background: Studies on the relationship between left ventricular reverse remodeling and cardiopulmonary exercise capacity in heart failure patients undergoing cardiac resynchronization therapy (CRT) are scarce and inconclusive.Methods and results: Eighty-four patients with a 1st-time CRT-defibrillator (mean age 65 ± 11; 73% male) underwent echocardiography and cardiopulmonary exercise testing (CPX) before implantation (baseline) and 6 months after implantation. At baseline, patients also completed a set of questionnaires measuring mental and physical health. The association between echocardiographic response (left ventricular end-systolic volume decrease ≥15%) and a comprehensive set of CPX results was examined. Echocardiographic responders (54%) demonstrated higher peak oxygen consumption and better exercise performance than nonresponders at baseline and at 6-month follow-up. Furthermore, only echocardiographic responders showed improvements in ventilatory efficiency during follow-up. Multivariable repeated measures analyses revealed that, besides reverse remodeling, New York Heart Association functional class II and good patient-reported health status before implantation were the most important correlates of higher average oxygen consumption during exercise, and that nonischemic etiology and smaller pre-implantation QRS width were associated with better ventilatory efficiency over time.Conclusions: During the first 6 months of CRT there was a significant positive association between reverse remodeling and cardiopulmonary exercise capacity.

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DO - 10.1016/j.cardfail.2015.08.342

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JO - Journal of Cardiac Failure

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