Impact of septal flash and left ventricle contractile reserve on positive remodeling during 1 year cardiac resynchronization therapy: the multicenter ViaCRT study

Gąsior, Zbigniew; Płońska‐Gościniak, Edyta; Kułach, Andrzej; Wita, Krystian; Mizia-Stec, Katarzyna; Szwed, Hanna; Kasprzak, Jarosław D.; Tomaszewski, A.; Sinkiewicz, Włądysław; Wojciechowska, Celina

doi:10.5114/aoms.2016.59260

Cited by 6 publications

(9 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While pharmacological therapy has signifi- 2 Arch Med Sci cantly improved clinical outcome in patients with HF and reduced ejection fraction (HFrEF), a subgroup still remains symptomatic and with poor quality of life [2]. This limited clinical improvement urged researchers and clinicians to identify other therapeutic potentials that could alleviate symptoms in such patients [3], particularly those requiring cardiac resynchronisation therapy (CRT) [4]. Despite being considered the best treatment for symptomatic HF patients on full medical therapy, one third of subjects receiving CRT do not respond [5,6].…”

Section: Introductionmentioning

confidence: 99%

Left atrial volume index predicts response to cardiac resynchronisation therapy: a systematic review and meta-analysis

2020

View full text Add to dashboard Cite

Introduction: In responders, cardiac resynchronisation therapy (CRT) results in improved left ventricular (LV) function and reduced atrial arrhythmia. The aim of this meta-analysis was to assess the potential relationship between the left atrium (LA) volume and CRT response. Material and methods: We systematically searched all electronic databases up to August 2018 in order to select clinical trials and observational studies that assessed the predictive value of LA volume index (LAVI) of CRT response. Left ventricular end-systolic volume (LVESV) reduction ≥ 15 ml and/ or LV ejection fraction (EF) increase ≥ 10% were the documented criteria for positive CRT response. Results: A total of 2191 patients recruited in 10 studies with mean follow-up duration of 10.5 months were included in this meta-analysis. The pooled analysis showed that CRT responders had lower baseline LAVI compared to non-responders, with a weighted mean difference (WMD) of-5.89% (95% CI:-9.47 to-3.22, p < 0.001). At follow-up, LAVI fell in the CRT responders (WMD-4.36%, 95% CI:-3.54 to-5.17, p < 0.001) compared to non-responders (WMD 1.45 %, 95% CI:-0.75 to 3.65, p = 0.20). The mean change of LAVI in the CRT responders was related to the fall in LVESV, β =-1.02 (-1.46 to-0.58), p < 0.001 and the increase in LVEF, β = 2.02 (1.86 to 4.58), p = 0.001. A baseline LAVI < 34 ml/m 2 predicted CRT response with summary sensitivity 0.80% (0.53-0.95), specificity 0.74% (0.53-0.89), and odds ratio > 11. Conclusions: Baseline LAVI predicts CRT response, and its reduction reflects devise-related LA remodelling. These results emphasis the role of LAVI assessment as an integral part of cardiac function response to CRT.

show abstract

Section: Introductionmentioning

confidence: 99%

Left atrial volume index predicts response to cardiac resynchronisation therapy: a systematic review and meta-analysis

2020

View full text Add to dashboard Cite

show abstract

“…Third, 3 in 4 patients in our study had vegetations that could be visualised using echocardiography [12,19,22]. Echocardiography is an established method for both qualifying patients for CRT therapy and assessing its response [23,24]. Our findings show that echocardiography also plays a key role in diagnosing CRT-related CDRIE, particularly in the absence of positive blood cultures.…”

Section: 5%mentioning

confidence: 66%

Clinical manifestations of device-related infective endocarditis in cardiac resynchronization therapy recipients

et al. 2021

View full text Add to dashboard Cite

The aim of the study was to analyse microbiological characteristics and clinical manifestations of cardiac device-related infective endocarditis (CDRIE) in cardiac resynchronization therapy (CRT) recipients, and to compare the diagnostic value of modified Duke (MDC) versus modified Duke lead criteria (MDLC; including to MDC local infection and pulmonary infection or embolism as major criteria). Material and methods: The study population comprised 765 consecutive CRT patients from a high-volume, tertiary care centre from 2002 to 2015. All patients were screened for CDRIE. Results: During a median follow-up of 1692 days (range: 457-3067) 5.36% of patients (n = 41) developed CDRIE, which was accompanied by CRT pocket infection in 17.1% (n = 7) and recurrent pulmonary infection or pulmonary embolism in 29.3% (n = 12). Fever was present in 95.1% of patients (n = 39), whereas blood cultures were positive in 65.9% (n = 27). Staphylococcus was the most prevalent pathogen in 59.3% (n = 16), Gram-negative bacteria in 25.9% (n = 7). Transoesophageal echocardiography showed intracardiac vegetations in 73.2% of patients (n = 30). Non-different pathogen types with the most common methicillin-sensitive Staphylococcus aureus were observed for early versus late CDRIE (endocarditis ≤ 6 vs. > 6 months from CRT or other device-related procedure). All 3 inflammatory markers (C-reactive protein, white blood cells, procalcitonin) were normal in 4.9% of patients (n = 2). MDC versus MDLC indicated definite CDRIE in 48.8% versus 80.5%, respectively (p = 0.003). Conclusions: Fever is the most common symptom of CRT-related CDRIE, and transoesophageal echocardiography allows vegetations to be visualised in nearly 3/4 of patients with CDRIE. Although the most common pathogens were Staphylococci, Gram-negative bacteria accounted for a quarter of CDRIE. Modified Duke lead criteria proved superior to MDC.

show abstract

“…Our search yielded 543 studies and after detailed screening and review, a total of nine studies were included [ Figure 2 ]. [ 13 14 15 18 19 20 21 22 23 ]…”

Section: R Esultsmentioning

confidence: 99%

“…All studies used either two-dimensional (2D or 3D) TTE to assess for the presence of septal flash. [ 13 14 15 18 19 20 21 22 ] One study used a combination of 2D TTE and CMR. [ 23 ] Details results extracted from each of the included studies is shown in Table 3 .…”

Section: R Esultsmentioning

confidence: 99%

“…[ 13 14 15 18 19 22 23 ] There was no definition for the assessment of septal flash in two studies. [ 20 21 ] Outcomes measures included TTE parameters (improvement in LVEF and a reduction in LV volumes) and clinical characteristics (improvement in NYHA classification and survival rates at follow-up). Outcomes were assessed with the evaluation of TTE, CMR or events from medical records.…”

Section: R Esultsmentioning

confidence: 99%

See 1 more Smart Citation

Septal Flash as a Predictor of Cardiac Resynchronization Therapy Response: A Systematic Review and Meta-Analysis

Bennett

Tafuro

Duckett

et al. 2021

J Cardiovasc Echography

View full text Add to dashboard Cite

Cardiac resynchronization therapy (CRT) in heart failure patients has been shown to improve patient outcomes in some but not all patients. A few studies have identified that septal flash on imaging is associated with response to CRT, but there has yet to be systematic review to evaluate the consistency of the finding across the literature. A search of MEDLINE and EMBASE was conducted to identify studies, which evaluate septal flash and its association with CRT response. Studies that met the inclusion criteria were statistically pooled with random-effects meta-analysis and heterogeneity was assessed using the I 2 statistic. A total of nine studies were included with 2307 participants (mean age 76 years, 67% male). Septal flash on imaging before CRT implantation was seen in 53% of patients and the proportion of CRT responders from the included studies varied from 52% to 77%. In patients who were CRT responders, septal flash was seen in 40% of patients compared to 10% in those deemed to be CRT nonresponders. Meta-analysis of eight of the nine included studies suggests that the presence of septal flash at preimplant was associated with an increased likelihood of CRT response (relative risk 2.55 95% confidence interval 2.04–3.19, P < 0.001, I 2 = 51%). Septal flash was also reported to be associated with left ventricular reverse remodeling, but the association with survival and symptomatic improvement was less clear. Septal flash is a well-defined and distinctive contraction pattern that is easily recognizable on cardiac imaging. Septal flash may be associated with CRT response and should be evaluated in the patients that are considered for CRT devices.

show abstract

Impact of septal flash and left ventricle contractile reserve on positive remodeling during 1 year cardiac resynchronization therapy: the multicenter ViaCRT study

Cited by 6 publications

References 10 publications

Left atrial volume index predicts response to cardiac resynchronisation therapy: a systematic review and meta-analysis

Left atrial volume index predicts response to cardiac resynchronisation therapy: a systematic review and meta-analysis

Clinical manifestations of device-related infective endocarditis in cardiac resynchronization therapy recipients

Septal Flash as a Predictor of Cardiac Resynchronization Therapy Response: A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About