Key result
Cardiac resynchronization therapy in DCM patients with baseline QRS ⩽130 ms resulted in a higher response rate at 6 months compared to those with QRS <130 ms (77.5% vs 20%, p=0.001).
Why the study?
Does a baseline QRS width ≥ 130 ms improve functional mitral regurgitation and response to CRT in patients with advanced dilated cardiomyopathy?
Case-Control (n=50)
No
Does a baseline QRS width ≥ 130 ms improve functional mitral regurgitation and response to CRT in patients with advanced dilated cardiomyopathy?
Absolute Event Rate: 77.5% vs 20%
p-value: p=0.001
In patients with advanced dilated cardiomyopathy undergoing CRT, a baseline QRS width ≥ 130 ms is associated with significantly greater improvement in functional mitral regurgitation and overall CRT response compared to QRS < 130 ms.
The effect of cardiac resynchronization therapy (CRT) on functional mitral regurgitation (FMR) is reflected on both clinical and echocardiographic response. We sought to assess the behavior of FMR and the response to CRT implantation in relation to the baseline width of the QRS complex among patients with dilated cardiomyopathy (DCM). This is a prospective observational case-control study, including forty patients with advanced DCM who had left bundle branch block (LBBB), QRS ⩾ 130 ms (group 1) and 10 patients with QRS < 130 ms (group 2) both with echocardiographic evidence of dyssynchrony and subjected to CRT in our center. Evidence of response to CRT at 6 months, was observed in 31 patients (77.5%) of group 1 Vs 2 (20%) patients of group 2 (p. 0.001). MR improvement was higher among responders to CRT in 31/33 (93.9%) Vs 2/17 patients (11.7%) of the non responders (p. 0.003). FMR improvement was observed in 31 patients of group 1 (77.5%) Vs 2 patients of group 2 (20%) p. value 0.001. Among patients with DCM, the degree of FMR regression after CRT seems to be more clear in patients with a baseline QRS width ⩾130 ms and this seems to be associated with better response of the patients to CRT.
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Atta et al. (2013) conducted a case-control in Dilated cardiomyopathy (DCM) (n=50). Cardiac resynchronization therapy (CRT) in patients with QRS ⩽ 130 ms vs. CRT in patients with QRS < 130 ms was evaluated on Evidence of response to CRT at 6 months (p=0.001). Cardiac resynchronization therapy in DCM patients with baseline QRS ⩽130 ms resulted in a higher response rate at 6 months compared to those with QRS <130 ms (77.5% vs 20%, p=0.001).
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