Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2006 Aug;92(8):1091-5.
doi: 10.1136/hrt.2005.071654. Epub 2005 Dec 30.

Cardiac resynchronisation therapy reduces functional mitral regurgitation during dynamic exercise in patients with chronic heart failure: an acute echocardiographic study

P-V Ennezat  1 , B Gal, C Kouakam, C Marquie, T LeTourneau, D Klug, D Lacroix, D Logeart, A Cohen-Solal, S Dennetière, E Van Belle, G Deklunder, P Asseman, P de Groote, S Kacet, T H LeJemtel
Affiliations

Cardiac resynchronisation therapy reduces functional mitral regurgitation during dynamic exercise in patients with chronic heart failure: an acute echocardiographic study

P-V Ennezat et al. Heart. 2006 Aug.

Abstract

Objectives: To assess non-invasively the acute effects of cardiac resynchronisation therapy (CRT) on functional mitral regurgitation (MR) at rest and during dynamic exercise.

Methods: 21 patients with left ventricular (LV) systolic dysfunction and functional MR at rest, treated with CRT, were studied. Each patient performed a symptom-limited maximal exercise with continuous two dimensional Doppler echocardiography twice. The first exercise was performed with CRT; the second exercise was performed without CRT. Mitral regurgitant flow volume (RV), effective regurgitant orifice area (ERO) and LV dP/dt were measured at rest and at peak exercise.

Results: CRT mildly reduced resting mitral ERO (mean 8 (SEM 2) v 11 (2) mm(2) without CRT, p = 0.02) and RV (13 (3) v 18 (3) ml without CRT, p = 0.03). CRT attenuated the spontaneous increase in mitral ERO and RV during exercise (1 (1) v 9 (2) mm(2), p = 0.004 and 1 (1) v 8 (2) ml, p = 0.004, respectively). CRT also significantly increased exercise-induced changes in LV dP/dt (140 (46) v 479 (112) mm Hg/s, p < 0.001).

Conclusion: Attenuation of functional MR, induced by an increase in LV contractility during dynamic exercise, may contribute to the beneficial clinical outcome of CRT in patients with chronic heart failure and LV asynchrony.

PubMed Disclaimer

References

    1. Selzer A, Katayama F. Mitral regurgitation: clinical patterns, pathophysiology and natural history. Medicine 197251337–366. - PubMed
    1. Lebrun F, Lancellotti P, Pierard L. Quantitation of functional mitral regurgitation during bicycle exercise in patients with heart failure. J Am Coll Cardiol 2001381685–1692. - PubMed
    1. Lapu‐Bula R, Robert A, Van Craeynest D.et al Contribution of exercise‐induced mitral regurgitation to exercise stroke volume and exercise capacity in patients with left ventricular dysfunction. Circulation 20021061342–1348. - PubMed
    1. Cazeau S, Leclercq C, Lavergne T.et al Effects of multisite biventricular pacing in patients with heart failure and intraventricular conduction delay. N Engl J Med 2001344873–880. - PubMed
    1. Cleland J, Daubert J, Erdmann E.et al The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med 20053521539–1549. - PubMed