Objectives The aim of this study is to observe the effect of 12 months after therapy of CRT in patients with congestive heart failure, to investigate the change of serum inflammation factors in these patients.
Methods Twenty patients (mean age 58.4 ± 14.3 years) with Left ventricular end-diastolic dimention (LVEDD) ≥55 mm, Left ventricular ejection fraction (LVEF) ≤35%, and QRS duration ≥120 ms were divided into 2 groups,10 patients received biventricular pacing therapy and optimal medical therapy (CRT group) including diuretics, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, βblockers, spironolactone, digoxin and the other 10 patients received the same optimal medical therapy (contrast group). Investigations were performed before (at baseline) and 1 months, 6 months and 12 months respectively after CRT together with optimal medical therapy or optimal medical therapy alone. They include 6-minute hall-walking test (6MWT), echocardiography (to survey LVEDD, LVEF). The blood of the two groups was collected before breakfast to measure serum level of TNF-α, IL-6, MCP-1 and hs-CRP.
Results 1. Heart function and exercise tolerance: At 1 month, 6 month and 12 month follow-up,6 MWT improved in CRT group compared with baseline values (P < 0.05∼0.01), and compared with that in contrast group (P < 0.05∼0.01), LVEF was improved in CRT group compared with baseline values (P < 0.05∼0.01), and compared with that in contrast group (P < 0.05). LVEDD in CRT group was improved too compared with baseline values (P < 0.05∼0.01) in 1months, 6 months and 12 months, and compared with that in contrast group (P < 0.05) at 6 month and 12 months. 2. Inflammation factors concentration: At 1month follow-up, The serum TNF-α, IL-6, MCP-1 and hs-CRP concentration were tend todecrease in CRT group, could not achieve statistical difference (P > 0.05) compared with baseline, and at 6 month follow-up, them were decreased significantly in CRT group (P < 0.01 compared with baseline), achieved statistical difference than contrast group (P < 0.05).
Conclusions CRT,a pacemaker-based therapy for heart failure, helps to correct hemodynamic disturbance,enhances quality of life and heart function by reversing LV remodelling, improving LVEF and decrease serum inflammation factors.