Key result
Early pacing-induced reduction in the ratio of transversal to longitudinal hemodynamic forces accurately predicted positive response to cardiac resynchronization therapy at mid-term follow-up (AUC 0.891).
Why the study?
The rate of non-responders to CRT remains high, and whether pacing-induced realignment of hemodynamic forces relates to a positive CRT response is unclear.
Does early pacing-induced realignment of hemodynamic forces predict left ventricular reverse remodeling in heart failure patients undergoing cardiac resynchronization therapy?
Population
38 patients from a single-institution CRT database
Comparison
Early pre- vs post-CRT implantation assessments of hemodynamic forces
Design
Retrospective cohort study
Follow-up
≥ 6 months
Authors
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May aid early CRT response prediction via hemodynamic forces; hypothesis-generating pending prospective validation.
Observational (n=38)
No
Does early pacing-induced realignment of hemodynamic forces predict left ventricular reverse remodeling in heart failure patients undergoing cardiac resynchronization therapy?
Effect estimate: AUC 0.891 (95% CI 0.787-0.995)
p-value: p=<0.001
Early pacing-induced realignment of hemodynamic forces assessed by speckle-tracking echocardiography is a strong predictor of left ventricular reverse remodeling and response to CRT.
Ferro et al. (2019) conducted an observational in Heart failure with reduced ejection fraction (HFrEF) (n=38). Cardiac Resynchronization Therapy (CRT) vs. Baseline (Pre-CRT) was evaluated on Prediction of all-grade responder status (LVESV reduction ≥15%) at mid-term follow-up using early change in RMSx/RMSz ratio (δRMSx/RMSz) (AUC 0.891, 95% CI 0.787-0.995, p=<0.001). Early pacing-induced reduction in the ratio of transversal to longitudinal hemodynamic forces accurately predicted positive response to cardiac resynchronization therapy at mid-term follow-up (AUC 0.891).
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