TY - JOUR T1 - Restrictive transmitral filling patterns predict improvements in left ventricular function after biventricular pacing JF - Heart JO - Heart SP - 1087 LP - 1088 DO - 10.1136/heart.89.9.1087 VL - 89 IS - 9 AU - R Thaman AU - R T Murphy AU - S Firoozi AU - S M Hamid AU - J R Gimeno AU - B Sachdev AU - V Paul AU - E Rowland AU - M P Frenneaux AU - P M Elliott Y1 - 2003/09/01 UR - http://heart.bmj.com/content/89/9/1087.abstract N2 - Numerous studies have shown that biventricular pacing (BVP) improves symptoms and exercise capacity in patients with congestive cardiac failure (CCF) and left bundle branch block (LBBB). The mechanism of symptomatic improvement has been attributed to changes in ventricular synchrony. However, the degree of asynchrony is not a good predictor of response.1,2 The aim of this study was to assess whether the presence of a restrictive mitral filling pattern, previously shown to be a marker for diastolic ventricular interaction (DVI) in patients with CCF,3 might identify a cohort of patients more likely to respond to BVP. We studied 23 consecutively referred patients (15 males/8 females), mean (SD) age 63.4 (12.8) years (range 40–83 years) in sinus rhythm with severe refractory heart failure (New York Heart Association (NYHA) III/IV), LBBB (QRS > 120 ms), and fractional shortening (FS) < 25% on maximal tolerated doses of medication, Clinical evaluation included history, ECG, M mode and two dimensional echocardiography before and six months after BVP. At six month follow up patients were classified as responders if there was an improvement in FS > 5% from baseline. Implantation of the biventricular system was successful in 19 patients (83%). Before implant, all patients were receiving either an angiotensin converting enzyme inhibitor or an angiotensin II blocker. All patients were receiving frusemide (furosemide) (mean (SD) dose was 119 (46) … ER -