Tighter is better: Can a simple and cost‐free parameter predict response to cardiac synchronization therapy?
Background: Several studies have evaluated the role of QRS duration (QRSd) or QRS narrowing as a predictor of response to cardiac resynchronization therapy (CRT) to reduce nonresponders. Aim: Our study aimed to determine the correlation between the relative change in QRS index (QI) compared to clini...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 47; no. 7; pp. 966 - 974 |
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| Autores principales: | , , , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jul2024
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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=178296945&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 178296945 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Jul2024 vid: 47 iid: 7 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 178296945 177592358 178296945 178296945 10.1111/pace.15021 178296945 ppf: 966 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Tighter is better: Can a simple and cost‐free parameter predict response to cardiac synchronization therapy? aug: au: Coppola, Giuseppe Madaudo, Cristina Mascioli, Giosuè D'Ardia, Giulio Greca, Carmelo La Prezioso, Amedeo Corrado, Egle affil: Operative Unit of Cardiology ‐ UTIC, University Hospital "Paolo Giaccone", University of Palermo, AOUP Paolo Giaccone, Via del Vespro 129, Palermo, Italy sug: subj: Cardiac Resynchronization Therapy Utilization Defibrillators, Implantable Utilization QRS Complex Evaluation Heart Failure Therapy Heart Failure Physiopathology Heart Failure Prognosis Treatment Outcomes Human Male Female Retrospective Design Record Review Multicenter Studies Correlational Studies Ventricular Ejection Fraction Comparative Studies Descriptive Statistics Electrocardiography Ventricular Remodeling Male Female ab: Background: Several studies have evaluated the role of QRS duration (QRSd) or QRS narrowing as a predictor of response to cardiac resynchronization therapy (CRT) to reduce nonresponders. Aim: Our study aimed to determine the correlation between the relative change in QRS index (QI) compared to clinical outcome and prognosis in patients who underwent CRT implantation. Methods: A three‐centers study involving 398 patients with a CRT device was conducted. Clinical, echocardiographic and pharmacological variables, QRSd before and after CRT implantation and QI were measured. Results: In a 6‐month follow‐up, a significant improvement in left ventricular ejection fraction (LVEF), left ventricular end‐diastolic and systolic volumes (LVEDV and LVESV) were observed. QI was related to reverse remodeling (multiple r‐squared: 0.48, adjusted r‐squared: 0.43, p =.001), and the cut‐off value that best predicted LV reverse remodeling after 6 months of CRT was 12.25% (AUC 0.7, p =.001). At 24 months, a statistically significant difference was found between patients with a QI ≤ 12.25% and those with a QI > 12.25% regarding NYHA class worsening (p =.04). The mean of the QI of patients who died from cardiovascular causes was lower than patients who died of other causes (p =.0179). A correlation between pre‐CRT QRSd/LVEDV and QI was observed (r = + 0.20; p =.0003). A higher QRSd/LVEDV ratio was associated with an improved LVEF, LVEDV, and LVESV (p <.0001) at follow‐up. Conclusions: QI narrowing after CRT was related to greater echocardiographic reverse remodeling and a lower rate of adverse events (death or cardiovascular hospitalizations). The QI can improve the prediction of adverse events in a population with CRT regardless of comorbidities according to the Charlson Comorbidity Index. QI could be used to predict CRT response. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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