Relationship of visually assessed apical rocking and septal flash to response and long-term survival following cardiac resynchronization therapy (PREDICT-CRT).
AIMS: Apical rocking (ApRock) and septal flash (SF) are often observed phenomena in asynchronously contracting ventricles. We investigated the relationship of visually assessed ApRock and SF, reverse remodelling, and long-term survival in cardiac resynchronization therapy (CRT) candidates. METHODS A...
| Publicado en: | European Heart Journal - Cardiovascular Imaging Vol. 17; no. 3; pp. 262 - 270 |
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| Autores principales: | , , , , , , , , , , , , , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
Mar2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=113202395&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 113202395 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 20472404 BMSM jtl: European Heart Journal - Cardiovascular Imaging issn: 20472404 maglogo: N pubinfo: dt: Mar2016 vid: 17 iid: 3 pid: 622 pub: Oxford University Press / USA artinfo: ui: 113202395 113202395 113202395 10.1093/ehjci/jev288 113202395 ppf: 262 ppct: 8 formats: tig: atl: Relationship of visually assessed apical rocking and septal flash to response and long-term survival following cardiac resynchronization therapy (PREDICT-CRT). aug: au: Ciarka, Agnieszka Daraban, Ana Maria Willems, Rik Voigt, Jens-Uwe Stankovic, Ivan Neskovic, Aleksandar N. Prinz, Christian van Faber, Lothar Kotrc, Martin Penicka, Martin Aarones, Marit Aakhus, Svend Szulik, Mariola Kukulski, Tomasz Winter, Stefan Fehske, Wolfgang Belmans, Ann affil: Department of Cardiovascular Diseases, University Hospital Gasthuisberg, Catholic University Leuven, Herestraat 49, Leuven 3000, Belgium sug: subj: Cardiac Resynchronization Therapy Cause of Death Computer Terminals QRS Complex Survival Human Prostheses and Implants Descriptive Statistics Post Hoc Analysis Heart Assist Devices Confidence Intervals ab: AIMS: Apical rocking (ApRock) and septal flash (SF) are often observed phenomena in asynchronously contracting ventricles. We investigated the relationship of visually assessed ApRock and SF, reverse remodelling, and long-term survival in cardiac resynchronization therapy (CRT) candidates. METHODS AND RESULTS: A total of 1060 patients eligible for CRT underwent echocardiographic examinations before and 12 ± 6 months after device implantation. Three blinded physicians were asked to visually assess the presence of ApRock and SF before device implantation and also their correction by CRT 12 ± 6 months post-implantation. Patients with a left ventricular (LV) end-systolic volume decrease of ≥15% during the first year of follow-up were regarded as responders. Patients were followed for a median period of 46 months (interquartile range: 27-65 months) for the occurrence of death of any cause. If corrected by CRT, visually assessed ApRock and SF were associated with reverse remodelling with a sensitivity of 84 and 79%, specificity of 79 and 74%, and accuracy of 82 and 77%, respectively. ApRock (hazard ratio [HR] 0.40, 95% confidence interval [CI] 0.30-0.53, P < 0.0001) and SF (HR 0.45 [CI 0.34-0.61], P < 0.001) were independently associated with lower all-cause mortality after CRT and had an incremental value over clinical variables and QRS width for identifying CRT responders. Both the absence of ApRock/SF and unsuccessful correction of ApRock/SF despite CRT were associated with a high risk for non-response and an unfavourable long-term survival. CONCLUSION: A specific LV mechanical dyssynchrony pattern, characterized by ApRock and SF, is associated with a more favourable long-term survival after CRT. Both parameters are also indicators of an effective therapy. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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