Neurohormonal and Anatomical Remodeling After Ventricular Resynchronization Therapy: Does It Really Happen?

摘要

Chronic heart failure is a global public health problem. The incidence of heart failure is very high among developed nations and contributes significantly to the cost of medical care. It is a very common cause of hospitalization for elderly patients [1]. In addition to the morbidity associated with heart failure, it remains very lethal. Despite advances in the medical therapy of heart failure, the projected 5-year mortality remains greater than 50% at 5 years [2]. Accordingly, new treatments are needed.Recently, attention has been drawn to the potential of cardiac resynchro-nization therapy (CRT) to improve the symptoms and functional capacity of patients with heart failure. CRT is the use of ventricular pacing at either specific sites or multiple sites to improve contractile performance in patients with intraventricular conduction delays and discoordinated ventricular contraction. CRT has been studied in selected patients and produced improvement in acute hemodynamics, exercise capacity, symptoms, quality of life, and left ventricular size and function [3-5]. However, long-term effects of CRT are not yet known.