Key result
Left ventricular anterior-wall standard deviation (OR 1.5275; 95% CI 1.1472-2.0340; p=0.0037) and summed rest score independently predicted response to cardiac resynchronization therapy.
Why the study?
Approximately 30% of heart failure patients are nonresponsive to CRT, prompting investigation into whether left ventricular mechanical dyssynchrony and scar burden predict CRT response.
Does assessment of left ventricular mechanical dyssynchrony and scar burden predict echocardiographic response to CRT in patients with heart failure and LBBB?
Observational (n=56)
Does assessment of left ventricular mechanical dyssynchrony and scar burden predict echocardiographic response to CRT in patients with heart failure and LBBB?
Odds Ratio: 1.5275 (95% CI 1.1472–2.034)
p-value: p=0.0037
Scar burden and mechanical dyssynchrony assessed by cardiac scintigraphy independently predict echocardiographic response to CRT in heart failure patients.
Scar burden and LV MD may aid CRT response prediction in small observational cohorts; leaves open need for prospective validation before guiding selection.
Background: Cardiac resynchronization therapy (CRT) improves the outcome in patients with heart failure (HF). However, approximately 30% of patients are nonresponsive to CRT. The aim of this study was to determine the role of the left ventricular (LV) mechanical dyssynchrony (MD) and scar burden as predictors of CRT response. Methods: In this study, we included 56 patients with HF and the left bundle-branch block with QRS duration ≥ 150 ms who underwent CRT-D implantation. In addition to a full examination, myocardial perfusion imaging and gated blood-pool single-photon emission computed tomography were performed. Patients were grouped based on the response to CRT assessed via echocardiography (decrease in LV end-systolic volume ≥15% or/and improvement in the LV ejection fraction ≥5%). Results: In total, 45 patients (80.3%) were responders and 11 (19.7%) were nonresponders to CRT. In multivariate logistic regression, LV anterior-wall standard deviation (adjusted odds ratio (OR) 1.5275; 95% confidence interval (CI) 1.1472–2.0340; p = 0.0037), summed rest score (OR 0.7299; 95% CI 0.5627–0.9469; p = 0.0178), and HF nonischemic etiology (OR 20.1425; 95% CI 1.2719–318.9961; p = 0.0331) were the independent predictors of CRT response. Conclusion: Scar burden and MD assessed using cardiac scintigraphy are associated with response to CRT.
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Atabekov et al. (2023) conducted an observational in Heart failure (n=56). Left ventricular mechanical dyssynchrony and scar burden was evaluated on Response to CRT (decrease in LV end-systolic volume ≥15% or/and improvement in the LV ejection fraction ≥5%) (OR 1.5275, 95% CI 1.1472-2.0340, p=0.0037). Left ventricular anterior-wall standard deviation (OR 1.5275; 95% CI 1.1472-2.0340; p=0.0037) and summed rest score independently predicted response to cardiac resynchronization therapy.
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