- 期刊
Fingertip Reactive Hyperemia Peripheral Arterial Tonometry Score Predicts Response to Biventricular Pacing
摘要
Purpose: The objectives of this study were to: (i) evaluate endothelial function via fingertip reactive hyperemia peripheral arterial tonometry (RH-PAT) among heart failure (HF) patients receiving cardiac resynchronization therapy (CRT), (ii) assess the effects of CRT on RH-PAT score, and (iii) investigate whether RH-PAT score can identify CRT response. Methods: A total of 63 patients (61.8 ± 10.3 years; 50 males; left ventricular (LV) ejection fraction 24.3 ± 3.9%) with HF who received CRT were enrolled. Endothelial function via RH-PAT was assessed 1 day before and 6 months after CRT. Minnesota Living with Heart Failure Questionnaire (MLWHFQ) was used to assess clinical improvements. CRT response was defined as a reduction in LV end-systolic volume ≥ 15% at 6 months. Results: A RH-PAT score of ＜ 1.7 signified a cut-off for endothelial dysfunction (ED). Baseline ED was observed among 43 (68.3%) patients and was more prevalent in responders (76.1% vs. 47.1%, p = 0.037). RH-PAT score improved 6 months after CRT (1.58 ± 0.35 vs. 1.71 ± 0.31, p = 0.012). A RH-PAT score of ＜ 1.7 was a significant independent predictor of CRT response in multivariate logistic regression analysis (β = 1.275, OR = 3.512, 95% CI = 1.231-11.477, p = 0.032). The severity of ED was an independent predictor of LV reverse remodeling (β = -8.873, p = 0.015). Spearman's correlation analysis revealed moderate positive correlations between an improvement in RH-PAT (∆RH-PAT) and LV reverse remodeling (r = 0.461, p = 0.001) and MLWHFQ score (r = 0.440, p = 0.001). Conclusions: ED detected via RH-PAT could predict the response to CRT. The RH-PAT score increased 6 months after CRT and was correlated with echocardiographic and clinical improvements.
延伸閱讀
- Hsu, H. P., Jou, Y. L., Wu, T. C., Chen, Y. H., Huang, S. S., Lin, Y. J., Lo, L. W., Hu, Y. F., Tuan, T. C., Chang, S. L., & Chen, S. A. (2012). Hyperglycemia Increases New-Onset Atrial Fibrillation in Patients with Acute ST-Elevation Myocardial Infarction. Acta Cardiologica Sinica, 28(4), 279-285. https://www.airitilibrary.com/Article/Detail?DocID=10116842-201212-201301210008-201301210008-279-285
- Liu, C. W., Liao, P. C., Wu, Y. W., & Ke, S. R. (2015). Hyperuricemia as an Outcome Predictor in Patients with ST-Segment Elevation Myocardial Infarction: Too Good to be True?. Acta Cardiologica Sinica, 31(1), 87-88. https://doi.org/10.6515/ACS20140721C
- Yildiz, O., & Yenigun, C. D. (2021). Prognostic Value of Right Ventricular Cardiac Power Output at Rest in Patients with Advanced Heart Failure. Acta Cardiologica Sinica, 37(4), 404-411. https://doi.org/10.6515/ACS.202107_37(4).20210123A
- Ferreira, J. P., Santos, M., Almeida, S., Marques, I., Bettencourt, P., & Carvalho, H. (2014). High-Sensitivity Troponin T: A Biomarker for Diuretic Response in Decompensated Heart Failure Patients. Cardiology Research and Practice, (2014), h1-9. https://doi.org/10.1155/2014/269604
- Patvardhan, E., Heffernan, K. S., Ruan, J., Hession, M., Warner, P., Karas, R. H., & Kuvin, J. T. (2011). Augmentation Index Derived from Peripheral Arterial Tonometry Correlates with Cardiovascular Risk Factors. Cardiology Research and Practice, 2011(), 222-227-027. https://doi.org/10.4061/2011/253758