Outcome of super-responders to cardiac resynchronization therapy defined by endpoint-derived parameters of left ventricular remodeling: a two-center retrospective study
Key result
Echocardiographic cut-offs defining super-response to CRT (except LVEF ≥ 25%) were significantly associated with improved clinical outcomes after 5 years.
Why the study?
Do specific echocardiographic cut-offs for LVEF, EDVI, and ESVI accurately identify CRT super-responders with improved clinical outcomes in patients after CRT implantation?
Population
542 patients after cardiac resynchronization therapy (CRT) implantation
Comparison
Super-response to CRT defined by… vs Non-super-responders
Design
Cohort
Follow-up
median 35.7 months
Authors
Discussion
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Member takes
Implication
Validates empirical echocardiographic cut-offs for CRT super-response; leaves open optimal parameters for prospective validation.
Study Design
Type
Cohort (n=542)
Multicenter
Yes
Structured PICO
Do specific echocardiographic cut-offs for LVEF, EDVI, and ESVI accurately identify CRT super-responders with improved clinical outcomes in patients after CRT implantation?
P
Population
542 patients after cardiac resynchronization therapy implantation, followed for a median of 35.7 months to validate echocardiographic definitions of super-response.
E
Exposure
Super-response to CRT defined by echocardiographic parameters (LVEF, EDVI, ESVI) using negative predictive value (NPV) and best quartile-based cut-offs
C
Comparator
Non-super-responders (patients not meeting the echocardiographic cut-offs)
O
Outcome
Composite of all-cause mortality, heart transplantation, ventricular assist device implantation (VAD), and hospitalization for heart failurecomposite
NPV- and best quartile-based echocardiographic cut-offs for EDVI and ESVI validate empirical definitions of CRT super-response and are significantly associated with improved long-term clinical outcomes.
Cite This Study
Hürlimann et al. (2014) conducted a cohort in Heart failure (post-CRT implantation) (n=542). Echocardiographic parameters of reverse remodeling (LVEF, EDVI, ESVI) vs. Non-super-responders was evaluated on Composite of all-cause mortality, heart transplantation, ventricular assist device implantation (VAD), and hospitalization for heart failure. Echocardiographic cut-offs defining super-response to CRT (except LVEF ≥ 25%) were significantly associated with improved clinical outcomes after 5 years.