Differentiating Electromechanical From Non–Electrical Substrates of Mechanical Discoordination to Identify Responders to Cardiac Resynchronization Therapy
Why the study?
Does a baseline systolic stretch index (SSI) ≥9.7% identify heart failure patients who have reduced heart failure hospitalizations or deaths following cardiac resynchronization therapy?
Population
191 patients with heart failure, including a subgroup of 113 patients with intermediate electrocardiographic…
Comparison
Cardiac resynchronization therapy in patients… vs Cardiac resynchronization therapy in patients…
Design
Cohort
Follow-up
2 years
Authors
Discussion
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Member takes
Implication
May aid CRT selection in observational cohorts; leaves open prospective validation before guiding therapy.
Structured PICO
Does a baseline systolic stretch index (SSI) ≥9.7% identify heart failure patients who have reduced heart failure hospitalizations or deaths following cardiac resynchronization therapy?
P
Population
191 patients with heart failure (QRS duration ≥120 ms; LV ejection fraction ≤35%), including a subgroup of 113 patients with intermediate electrocardiographic criteria (QRS duration of 120-149 ms or non-left bundle branch block).
I
Intervention
Cardiac resynchronization therapy (CRT) in patients with a baseline systolic stretch index (SSI) ≥9.7% quantified by automated echocardiographic radial strain analysis.
C
Comparator
Cardiac resynchronization therapy (CRT) in patients with a baseline systolic stretch index (SSI) <9.7%.
O
Outcome
Composite of heart failure hospitalizations or deaths at 2 years after CRT.composite
The novel echocardiography-derived systolic stretch index (SSI) identifies heart failure patients who benefit from CRT, including those with intermediate ECG criteria where response is less certain.
Cite This Study
Lumens et al. (2015) studied this question.