الفهرس 
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Abstract
Heart failure (HF) is the final destination of many cardiac disorders, which induce structural and/or functional impairment of ventricular filling or ejection. Presented by clinical symptoms and/or signs of reduced COP and/or pulmonary or systemic congestion at rest or with exercise associated with elevated natriuretic peptide levels.
Cardiac Resynchronization Therapy (CRT) is a huge step in the therapy of heart failure with reduced ejection fraction (HFrEF) as it was proved to correct electrical and mechanical dyssynchrony by coordinating contraction in both ventricles based on all the clinical trials concerned with CRT. CRT induced left ventricle (LV) reverse remodeling; however, its effects on right ventricular (RV) volumes and function were not well described in literature. Limited studies of low sample size focused on the RV.
Of 112 patients, 63 enrolled. All patients fulfilled criteria for CRT implantation and were followed at three and six-month intervals. Standard two (2D), three (3D) dimensional echocardiography, tissue Doppler imaging and speckle tracking analysis were conducted for assessment of both ventricles and left atrium (LA) volumes and function. Assessment of mitral, tricuspid valves and pulmonary artery systolic pressure (PASP) was included. Patients presenting with reduction of LVESV of >15% were termed LV responders for further statistical analysis.
Mean follow up period was 6.76 ± 1.25 months. Fourty-eight patients (76.2%) were volumetric responders (LVR) while the rest were non-responders (LVNR). Both groups were similar regarding baseline characteristics, risk factors, device implantation and programming values. Only LVR had significant reduction in RV basal diameter together with significant improvement in RV systolic performance. In addition, PASP decreased in LVR with improvement of TR severity. LV response, percentage change of RV4CSL, three-month LA ESVi and LA emptying fraction were the most independent predictors of RV response by multivariate analysis. Reduced LVESV >13.5 had 92.3% sensitivity and 81.8% specificity for prediction of RV response to CRT.