Akses terbuka Jurnal SINTA 1
Turning the tide in heart failure: A case report of one-year improvement in a CRT-P super-responder with HFrEF and LBBB
Heart Science Journal · Vol. 7 No. 4 (2026) · hlm. 90–94
- ISSN
- 2721-9984, 2721-9976
- Terbit
- 2026-10-13
- Penerbit
- Universitas Brawijaya
- Bahasa
- en
Abstrak
Background: Cardiac resynchronization therapy (CRT) is an established treatment for heart failure with reduced ejection fraction (HFrEF) and electrical dyssynchrony, especially in patients with left bundle branch block (LBBB). In symptomatic patients with LVEF ≤35%, sinus rhythm and LBBB with a QRS duration ≥130 ms despite optimal treatment, CRT is suggested according to the 2021 ESC Guidelines to enhance symptoms, quality of life, and survival. In older patients who are not candidates for a defibrillator, cardiac resynchronization therapy pacemaker (CRT-P) is generally used. Response rates are generally 55% to 70% in large trials, with optimal outcomes in patients with LBBB and QRS duration ≥150 ms. Case Presentations: A 76-year-old woman physician with hypertension and dyslipidaemia, despite optimal treatment, presented with NYHA class III. ECG revealed complete LBBB in sinus rhythm. Echocardiography demonstrated an LVEF of 28%, left ventricular dilation, and significant functional mitral regurgitation. Coronary angiography was negative for obstructive coronary artery disease. CRT-P was implanted. At 6 months, the patient was still a non-responder with persistent systolic dysfunction, adverse remodelling, diastolic dysfunction and residual regurgitation. Echocardiography-guided device optimization adjusting AV delay by transmitral Doppler to preserve atrial contribution, VV delay by LVOT VTI and strain analysis to improve synchronization and reduce regurgitation. At One-year follow-up, the patient showed significant improvement in NYHA class I–II and improved exercise tolerance. Echocardiography showed significant reverse remodelling, and LVEF was improved to 67%. Device interrogation revealed ongoing thresholds and >99% biventricular pacing. Conclusions: This case illustrates a CRT-P super-responder outcome, the role of guideline-directed selection, close follow-up, and tailored optimization to maximize both clinical and structural benefits.
Kata kunci
Jaringan kolaborasi para penulis
40 penulis · 255 tautan kepenulisan bersama · menampilkan 40 yang paling banyak terhubung
Arahkan kursor atau ketuk sebuah nama untuk menyorot rekan penulisnya. Klik dua kali untuk membuka halaman penulis.
- University of Brawijaya
- Afiliasi tidak diketahui
- Organisasi berbeda
- Organisasi sama
- Afiliasi tidak diketahui
- Garis lebih tebal = lebih banyak artikel bersama · lingkaran lebih besar = lebih banyak artikel
Tampilkan sebagai tabel
| Rekan penulis | Organisasi | Artikel bersama |
|---|---|---|
| Mohammad Saifur Rohman | University of Brawijaya | 21 |
| Anna Fuji Rahimah | University of Brawijaya | 18 |
| Indra Prasetya | University of Brawijaya | 13 |
| Sasmojo Widito | University of Brawijaya | 10 |
| Novi Kurnianingsih | University of Brawijaya | 10 |
| Setyasih Anjarwani | University of Brawijaya | 10 |
| Heny Martini | University of Brawijaya | 9 |
| Cholid Tri Tjahjono | University of Brawijaya | 6 |
| Valerinna Yogibuana | Afiliasi tidak diketahui | 6 |
| Djanggan Sargowo | University of Brawijaya | 5 |
| Adhika Prastya Wikananda | University of Brawijaya | 4 |
| Yoga Waranugraha | University of Brawijaya | 4 |
| N Kaputrin | University of Brawijaya | 4 |
| Budi Satrijo | University of Brawijaya | 3 |
| Icmi Dian Rochmawati | University of Brawijaya | 3 |
| Valerinna Yogibuana Swastika Putri | University of Brawijaya | 3 |
| Nikhen Noverike | University of Brawijaya | 3 |
| Gebryel Dennis Saerang | University of Brawijaya | 3 |
| Vemmy Lian Saputri | University of Brawijaya | 3 |
| Puspa Lestari | University of Brawijaya | 2 |
| Olivia Handayani | University of Brawijaya | 2 |
| Fahmy Rusnanta | University of Brawijaya | 2 |
| Anita Surya Santoso | Afiliasi tidak diketahui | 2 |
| Fitranti Suciati Laitupa | University of Brawijaya | 2 |
| Muhammad Saifur Rohman | Afiliasi tidak diketahui | 2 |
| Tri Astiawati | University of Brawijaya | 2 |
| Cik Kahadi | University of Brawijaya | 2 |
| Putri Annisa Kamila | University of Brawijaya | 1 |
| Djanggan Sargowo | Afiliasi tidak diketahui | 1 |
| Jonny Karunia Fajar | University of Brawijaya | 1 |
| Aditha Satria Maulana | University of Brawijaya | 1 |
| Aris Munandar Zulkifli Ismail | University of Brawijaya | 1 |
| Anna Fuji Rahimah | Afiliasi tidak diketahui | 1 |
| Aris Munandar ZI | Afiliasi tidak diketahui | 1 |
| Tonny Adriyanto | University of Brawijaya | 1 |
| Seprian Widasmara | University of Brawijaya | 1 |
| Faris Wahyu Nugroho | University of Brawijaya | 1 |
Afiliasi berasal dari OpenAlex; metadata OAI-PMH jurnal tidak memuatnya. Penulis tanpa ID OpenAlex dicocokkan berdasarkan nama, sehingga dua orang bisa tergabung atau satu orang bisa terpisah.