Predictors for Cardiac Resynchronization Therapy Response

H, Lin; Zhou, Ying; Xu, Geng

doi:10.1536/ihj.13-318

Cited by 9 publications

(2 citation statements)

References 24 publications

(27 reference statements)

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“…Analysis between responders and non-responders in this study showed no significant difference in clinical or biochemical variables. Both groups have CRT-D devices implanted in 80% of cases; this indicates a high risk of sudden cardiac death in the cohort and may correlate with greater severity of disease compared to other studies that had a greater proportion of patients implanted with CRT-Pacing 24,26 .…”

Section: Discussionmentioning

confidence: 80%

“…Our study used a definition of response to CRT that considered an improvement by clinical assessment (NYHA functional class) associated with LVEF improvement (≥ 5%) by echocardiography since it is the most widely used echocardiographic parameter due to its clinical prognostic value 23 . While it is true that there is no specific cutoff point for LVEF increase to consider a patient a responder, multiple studies have proposed a cutoff of at least 5% 18,24 . When assessing both aspects of the definition the rate of response in the population of our study was 50%.…”

Section: Discussionmentioning

confidence: 99%

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Predictores de respuesta a la terapia de resincronización cardíaca en insuficiencia cardíaca crónica: 10 años de experiencia en un centro cardiovascular

Plata-Corona,

Solis-Jiménez,

Flores-Flamand

et al. 2024

ACM

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Background: Cardiac resynchronization therapy (CRT) has been established as an effective therapy for heart failure with reduced ejection fraction. Randomized clinical trials have shown its impact on mortality and HF hospitalizations, as well as improvement of symptoms and quality of life. Objectives: Finding clinical, electrocardiographic, and echocardiographic variables that may predict the response to cardiac resynchronization therapy (CRT). Methods: We performed a single-center, observational, analytic, and retrospective study that included 102 patients with heart failure (HF) diagnosis who underwent CRT according to guideline-directed therapy from January 2010 to April 2020 in a third-level center. CRT response was defined as an improvement of New York Heart Association functional class in at least 1 category associated with a recovery of ≥ 5% in the left ventricular ejection fraction (LVEF). Results: Our study population was 102 patients of which 61 (59.8%) were men. The mean age at HF diagnosis was 54 ± 18.7 years. Ischemic heart disease was the etiology in 37 (36.3%) cases. Fifty-one (50%) patients were classified as responders. Responders had wider QRS, and lower LVEF and right ventricular fractional area change at baseline. After CRT, responders had a greater reduction of QRS duration, and improvement in LVEF, global longitudinal strain, and echocardiographic dyssynchrony parameters. Multivariate regression analysis showed that left bundle branch block (LBBB), left ventricular end-diastolic volume (LVEDV), tricuspid annular plane systolic excursion (TAPSE), and baseline difference of pre-ejection periods were predictors of a positive response to CRT in this population. Conclusions: LBBB, TAPSE, LVEDV, and pre-ejection time difference are independent variables that can predict adequate response to CRT.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Predictores de respuesta a la terapia de resincronización cardíaca en insuficiencia cardíaca crónica: 10 años de experiencia en un centro cardiovascular

Plata-Corona,

Solis-Jiménez,

Flores-Flamand

et al. 2024

ACM

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Timing Cycles

Hayes¹,

Wang²,

Asirvatham³

et al. 2021

Cardiac Pacing, Defibrillation and Resynchronization

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Prognostic Role of Right Ventricular Function in Patients With Heart Failure Undergoing Cardiac Resynchronization Therapy

Rapacciuolo

Maffè²,

Palmisano³

et al. 2016

Clinical Cardiology

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BACKGROUND:\ud \ud Because 20% to 40% of patients undergoing cardiac resynchronization therapy (CRT) do not respond to it, identification of potential factors predicting response is a relevant research topic.\ud HYPOTHESIS:\ud \ud There is a possible association between right ventricular function and response to CRT.\ud METHODS:\ud \ud We analyzed 227 patients from the Cardiac Resynchronization Therapy Modular Registry (CRT-MORE) who received CRT according to current guidelines from March to December 2013. Response to therapy was defined as a decrease of ≥15% in left ventricular end-systolic volume (LVESV) at 6 months.\ud RESULTS:\ud \ud The tricuspid annular plane systolic excursion (TAPSE) value that best predicted improvement in LVESV (sensitivity 68%, specificity 54%) was 17 mm. Stratifying patients according to TAPSE, LVESV decreased ≥15% in 78% of patients with TAPSE >17 mm (vs 59% in patients with TAPSE ≤17 mm; P = 0.006). At multivariate analysis, TAPSE >17 mm was independently associated with LVESV improvement (odds ratio: 1.97, 95% confidence interval: 1.03-3.80, P < 0.05), together with ischemic etiology (odds ratio: 0.39, 95% confidence interval: 0.20-0.75, P < 0.01). These results were confirmed for New York Heart Association class III to IV patients (79% echocardiographic response rate in patients with TAPSE >17 mm vs 55% in patients with TAPSE <17 mm; P = 0.012).\ud CONCLUSIONS:\ud \ud Baseline signs of right ventricular dysfunction suggest possible remodeling after CRT. A TAPSE value of 17 mm was identified as a good cutoff for predicting a better response to CRT in patients with both mildly symptomatic and severe heart failure

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Predictors for Cardiac Resynchronization Therapy Response

Cited by 9 publications

References 24 publications

Predictores de respuesta a la terapia de resincronización cardíaca en insuficiencia cardíaca crónica: 10 años de experiencia en un centro cardiovascular

Predictores de respuesta a la terapia de resincronización cardíaca en insuficiencia cardíaca crónica: 10 años de experiencia en un centro cardiovascular

Timing Cycles

Prognostic Role of Right Ventricular Function in Patients With Heart Failure Undergoing Cardiac Resynchronization Therapy

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