High acute haemodynamic response to cardiac resynchronization therapy (ΔdP/dt > 25%) predicted significantly better 12-month outcomes for hospitalizations and all-cause mortality (P=0.004).
Cohort (n=53)
Does a high acute haemodynamic response to CRT predict reduced hospitalizations and all-cause mortality in heart failure patients?
Echocardiographic assessment of acute haemodynamic response (LV dP/dt) to CRT predicts 12-month clinical outcomes in patients with heart failure, regardless of ischaemic or non-ischaemic aetiology.
p-value: p=0.004
AIMS: Although acute haemodynamic improvement in response to cardiac resynchronization therapy (CRT) is reflective of a favourable cardiac contractile response, there is limited information regarding not only its ability to predict long-term clinical outcome but also cardiac-substrate-specific differences in the prognostic value of this measure. METHODS AND RESULTS: Fifty-three heart failure patients (69 +/- 11 years) with low left ventricle ejection fraction (LVEF) (22 +/- 6%), wide QRS (169 +/- 31 ms), and indications for CRT were included. There were no significant differences in age, New York Heart Association (NYHA) class, medications, QRS width, or LVEF between ischaemic (n = 37) and non-ischaemic (n = 16) groups. Echocardiograms were performed within 24 h of implantation with device OFF and ON. Acute haemodynamic response was measured as LV dP/dt derived from the CW Doppler of mitral regurgitation. Percentage change in dP/dt was used to classify patients: high- (HR: DeltadP/dt > 25%) or poor-responders (PR: DeltadP/dt <or= 25%). Clinical response to CRT was defined by a combined endpoint of hospitalizations and all-cause mortality at 12 months. HR group had a significantly better outcome compared to the PR group (P-value = 0.004) irrespective of the aetiology of the cardiomyopathy. CONCLUSION: Echocardiographic assessment of the acute haemodynamic response to CRT predicts long-term clinical outcome in both ischaemic and non-ischaemic cardiomyopathy.
Tournoux et al. (Sun,) conducted a cohort in Heart failure (n=53). High acute haemodynamic response to CRT (ΔdP/dt > 25%) vs. Poor acute haemodynamic response to CRT (ΔdP/dt ≤ 25%) was evaluated on Combined endpoint of hospitalizations and all-cause mortality at 12 months (p=0.004). High acute haemodynamic response to cardiac resynchronization therapy (ΔdP/dt > 25%) predicted significantly better 12-month outcomes for hospitalizations and all-cause mortality (P=0.004).