Key result
QRS >145 ms, QRS shortening >20 ms, and aortic VTI >14 cm independently predict CRT response.
Why the study?
Prediction of response to cardiac resynchronization therapy in heart failure patients with intraventricular conduction delay using simple ECG and echocardiographic tools was investigated.
Do simple electrocardiographic and echocardiographic parameters predict response to cardiac resynchronization therapy in heart failure patients?
Observational (n=82)
Do simple electrocardiographic and echocardiographic parameters predict response to cardiac resynchronization therapy in heart failure patients?
Answers are grounded in this paper and cite their sources.
Simple ECG and echocardiographic parameters, specifically baseline QRS width, acute QRS shortening, and acute aortic VTI, can independently predict positive clinical and echocardiographic response to CRT.
AIMS: To predict response to cardiac resynchronization therapy (CRT) in patients with heart failure (HF) and intraventricular conduction delay. METHODS AND RESULTS: The study population consisted of 82 consecutive HF patients with standard CRT indications. Patients were classified as responders, if they were alive without cardiac decompensation and experienced >or=15% decrease in left ventricular end-systolic volume. Sixty-eight percent of the enrolled patients responded to CRT. When compared with non-responders, responders had a wider baseline QRS width (P = 0.001), more marked QRS shortening (DeltaQRS) immediately after CRT (P = 0.001), and a better improvement in aortic velocity time integral (VTI) 24 h after CRT (P = 0.02). Moreover, there was a trend towards a greater baseline intraventricular dyssynchrony in the responder group (P = 0.07). By multivariable logistic regression, the baseline QRS width (OR: 0.95, 95% CI: 0.90-0.97, P = 0.001), DeltaQRS (OR: 1.038, 95% CI: 1.012-1.064, P = 0.003), and acute aortic VTI (OR: 0.81, 95% CI: 0.68-0.96, P = 0.017) emerged as independent predictors of response to CRT. Receiver operating characteristic curve analysis identified a QRS width >145 ms, DeltaQRS >20 ms, and aortic VTI >14 cm to predict responders. CONCLUSION: A positive response to CRT was observed in 68% of the patients. Cardiac resynchronization therapy response is predictable using simple electrocardiographic and echocardiographic data.
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Bonakdar et al. (2009) conducted an observational in Heart failure and intraventricular conduction delay (n=82). Electrocardiographic and echocardiographic predictors (baseline QRS width, DeltaQRS, aortic VTI) was evaluated on Response to CRT (alive without cardiac decompensation and ≥15% decrease in left ventricular end-systolic volume) (OR 0.95, 95% CI 0.90-0.97, p=0.001). Baseline QRS width >145 ms, QRS shortening >20 ms, and aortic VTI >14 cm independently predicted a positive response to cardiac resynchronization therapy.
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