Electro-echocardiographic Indices to Predict Cardiac Resynchronization Therapy Non-response on Non-ischemic Cardiomyopathy

Abstract

Cardiac resynchronization therapy (CRT) threw lights on heart failure treatment, however, parts of patients showed nonresponse to CRT. Unfortunately, it lacks effective parameters to predict CRT non-response. In present study, we try to seek effective electro-echocardiographic predictors on CRT non-response. This is a retrospective study to review a total of 227 patients of dyssynchronous heart failure underwent CRT implantation. Logistic analysis was performed between CRT responders and CRT non-responders. The primary outcome was the occurrence of improved left ventricular ejection fraction 1 year after CRT implantation. We concluded that LVEDV > 255 mL (OR = 2.236; 95% CI, 1.016–4.923) rather than LVESV > 160 mL (OR = 1.18; 95% CI, 0.544–2.56) and TpTe/QTc > 0.203 (OR = 5.206; 95% CI, 1.89–14.34) significantly predicted CRT non-response. Oppositely, S wave > 5.7 cm/s (OR = 0.242; 95% CI, 0.089–0.657), E/A > 1 (OR = 0.211; 95% CI, 0.079–0.566), E’/A’ > 1 (OR = 0.054; 95% CI, 0.017–0.172), CLBBB (OR = 0.141; 95% CI, 0.048–0.409), and QRS duration >160 ms (OR = 0.52; 95% CI, 0.305–0.922) surprisingly predicted low-probability of CRT non-response.

Electrocardiographic parameters effectively predict ventricular tachycardia/fibrillation in acute phase and abnormal cardiac function in chronic phase of ST‐segment elevation myocardial infarction

“…QRS PVC duration rather than other ECG factors showed potential to predict LVEF decrease. QRS duration reflected ventricular depolarization, and prolonged QRS duration might be related to ventricular asynchrony and cardiac dysfunction . Previous study focused much on QRS duration of the sinus rhythmic complex; however, the relationship between QRS duration of PVC and LVEF was little known.…”

“…QRS duration reflected ventricular depolarization, and prolonged QRS duration might be related to ventricular asynchrony and cardiac dysfunction. 43 Previous study focused much on QRS duration of the sinus rhythmic complex; however, the relationship between QRS duration of PVC and LVEF was little known. Since PVC-induced cardiomyopathy had aroused attention recently, 44 the relationship between ECG and abnormal cardiac function after STEMI was testified here as well.…”

The mechanical effects of CRT promoting autophagy via mitochondrial calcium uniporter down‐regulation and mitochondrial dynamics alteration

“…Although CRT shows impressive performance in clinical practice, the molecular mechanism of CRT still remains unknown. Considering a number of patients do not respond to CRT, further study on the mechanism of CRT is helpful to deeply understand its principle and offer solution for improving the response rate of CRT. Consequently, distinct illumination of the mechanism of CRT on molecular level is important.…”

The Role of Echocardiography in the Optimization of Cardiac Resynchronization Therapy: Current Evidence and Future Perspectives

“…Severe diastolic dysfunction is hardly reversed by CRT so that LVEDV plays a major role in predicting CRT non-response. LVEDV >255 mL proved to be a valuable predictor of CRT non-response [ 37 ].…”