A Patient Selection Score for Cardiac Resynchronization Therapy

Shen, Xuedong; Nair, Chandra K.; Aronow, Wilbert S.; Hee, Tom; Pasupuleti, Suman; Holmberg, Mark J.; Wang, Fenwei; Esterbrooks, Dennis J.

doi:10.1111/j.1540-8175.2010.01301.x

“…The LBBB was traditionally a strong predictor of electrical LV discordance in numerous large trials [7,[31][32][33][34]. Our results are consistent with the findings of the MADIT-CRT [7], RAFT [35], and REVERSERS [36] trials, which have been shown that non-LBBB patients have an increased rate of mortality due to CRT compared to those with LBBB.…”

Section: Variables Associated With the Risk Of All-cause Mortality Ansupporting

confidence: 89%

A novel risk model for mortality and hospitalization following cardiac resynchronization therapy in patients with non-ischemic cardiomyopathy: the alpha-score

Yang

¹

,

Liu

²

,

Hu

³

et al. 2020

BMC Cardiovasc Disord

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Background: Non-ischemic cardiomyopathy (NICM) has been associated with a better left ventricle reverse remodeling response and improved clinical outcomes after cardiac resynchronization therapy (CRT). The aims of our study were to identify the predictors of mortality and heart failure hospitalization in patients treated with CRT and design a risk score for prognosis. Methods: A cohort of 422 consecutive NICM patients with CRT was retrospectively enrolled between January 2010 and December 2017. The primary endpoint was all-cause mortality and heart transplantation. Results: In a multivariate analysis, the predictors of all-cause death were left atrial diameter [Hazard ratio (HR): 1.

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“…The LBBB was traditionally a strong predictor of electrical LV discordance in numerous large trials [7,[31][32][33][34]. Our results are consistent with the findings of the MADIT-CRT [7], RAFT [35], and REVERSERS [36] trials, which have been shown that non-LBBB patients have an increased rate of mortality due to CRT compared to that in those with LBBBs.…”

Section: Variables Associated With the Risk Of All-cause Mortality Ansupporting

confidence: 90%

“…In this study, considering these factors, atrial size is a more reliable indicator of LA function. Although the mechanism remains uncertain, the larger LA size is associated with pulmonary hemodynamic alterations and LA dilatation dysfunction [7,34,39,41,42].…”

Section: Variables Associated With the Risk Of All-cause Mortality Anmentioning

confidence: 99%

A Novel Risk Model for Mortality and Hospitalization following Cardiac Resynchronization Therapy in Patients with Non-ischemic Cardiomyopathy: The Alpha-score

Yang

¹

,

Liu

²

,

Hu

³

et al. 2019

Preprint

0

View full text Add to dashboard Cite

Background: Non-ischemic cardiomyopathy (NICM) has been associated with a better left ventricle reverse remodeling response and improved clinical outcomes after cardiac resynchronization therapy (CRT). The aims of our study were to identify the predictors of mortality and heart failure hospitalization in patients treated with CRT and design a risk score for prognosis. Methods: A cohort of 422 consecutive NICM patients with CRT was retrospectively enrolled between January 2010 and December 2017. The primary endpoint was all-cause mortality and heart transplantation. Results: In a multivariate analysis, the predictors of all-cause death were left atrial diameter [Hazard ratio (HR): 1.056, 95% confidence interval (CI): 1.020-1.093, P=0.002]; non-left bundle branch block [HR: 1.793, 95% CI: 1.131-2.844, P =0.013]; high sensitivity C-reactive protein [HR: 1.081, 95% CI: 1.029-1.134 P= 0.002]; and N-terminal pro-B-type natriuretic peptide [HR: 1.018, 95% CI: 1.007-1.030, P =0.002]; and New York Heart Association class IV [HR: 1.018, 95% CI: 1.007-1.030, P =0.002]. The Alpha-score ( A trial diameter, non- L BBB, P ro-BNP, H s-CRP, NYH A class IV) was derived from each independent risk factor. The novel score had good calibration (Hosmer-Lemeshow test, P >0.05) and discrimination for both primary endpoints [c-statistics: 0.749 (95% CI: 0.694-0.804), P <0.001] or heart failure hospitalization [c-statistics: 0.692 (95% CI: 0.639-0.745), P <0.001]. Conclusion: The Alpha-score may enable improved discrimination and accurate prediction of long-term outcomes among NICM patients with CRT.

show abstract

“…The LBBB was traditionally a strong predictor of electrical LV discordance in numerous large trials [7, [31][32][33][34]. Our results are consistent with the findings of the MADIT-CRT[7], RAFT [35], and REVERSERS [36] trials, which have been shown that non-LBBB patients have an increased rate of mortality due to CRT compared to those with LBBB.…”

Section: Variables Associated With the Risk Of All-cause Mortality Ansupporting

confidence: 89%

“…In this study, considering these factors, atrial size is a more reliable indicator of LA function. Although the mechanism remains uncertain, the larger LA size is associated with pulmonary hemodynamic alterations and LA dilatation and dysfunction [7, 34,39,41,42].…”

Section: Variables Associated With the Risk Of All-cause Mortality Anmentioning

confidence: 99%

A Novel Risk Model for Mortality and Hospitalization following Cardiac Resynchronization Therapy in Patients with Non-ischemic Cardiomyopathy: The Alpha-score

Yang

¹

,

Liu

²

,

Hu

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background: Non-ischemic cardiomyopathy (NICM) has been associated with a better left ventricle reverse remodeling response and improved clinical outcomes after cardiac resynchronization therapy (CRT). The aims of our study were to identify the predictors of mortality and heart failure hospitalization in patients treated with CRT and design a risk score for prognosis. Methods: A cohort of 422 consecutive NICM patients with CRT was retrospectively enrolled between January 2010 and December 2017. The primary endpoint was all-cause mortality and heart transplantation. Results: In a multivariate analysis, the predictors of all-cause death were left atrial diameter Hazard ratio (HR):1.056, 95% confidence interval (CI): 1.020-1.093, P=0.002; non-left bundle branch block HR: 1.793, 95% CI: 1.131-2.844, P =0.013; high sensitivity C-reactive protein HR: 1.081, 95% CI: 1.029-1.134 P= 0.002; and N-terminal pro-B-type natriuretic peptide HR: 1.018, 95% CI: 1.007-1.030, P =0.002; and New York Heart Association class IV HR: 1.018, 95% CI: 1.007-1.030, P =0.002. The Alpha-score ( A trial diameter, non-L BBB, P ro-BNP, H s-CRP, NYH A class IV) was derived from each independent risk factor. The novel score had good calibration (Hosmer-Lemeshow test, P >0.05) and discrimination for both primary endpoints c-statistics: 0.749 (95% CI: 0.694-0.804), P <0.001 or heart failure hospitalization c-statistics: 0.692 (95% CI: 0.639-0.745), P <0.001. Conclusion: The Alpha-score may enable improved discrimination and accurate prediction of long-term outcomes among NICM patients with CRT.

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A Patient Selection Score for Cardiac Resynchronization Therapy

Abstract: Patients with a PSS >4 are the most likely to respond to CRT. Using this score system, a PSS score >4 can predict the probability of a CRT response up to 88% in patients with heart failure and a wide QRS duration.

Cited by 9 publications

References 46 publications

A novel risk model for mortality and hospitalization following cardiac resynchronization therapy in patients with non-ischemic cardiomyopathy: the alpha-score

A novel risk model for mortality and hospitalization following cardiac resynchronization therapy in patients with non-ischemic cardiomyopathy: the alpha-score

A Novel Risk Model for Mortality and Hospitalization following Cardiac Resynchronization Therapy in Patients with Non-ischemic Cardiomyopathy: The Alpha-score

A Novel Risk Model for Mortality and Hospitalization following Cardiac Resynchronization Therapy in Patients with Non-ischemic Cardiomyopathy: The Alpha-score

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