Key result
Higher baseline LAVI linked to ~40% lower odds of CRT response per 10 mL/m2.
Why the study?
Response to cardiac resynchronization therapy varies significantly, and the predictive value of left atrial indices for left ventricular reverse remodeling after CRT is unclear.
Do baseline echocardiographic left atrial indices predict left ventricular reverse remodeling after cardiac resynchronization therapy in CRT candidates?
Observational (n=99)
No
Do baseline echocardiographic left atrial indices predict left ventricular reverse remodeling after cardiac resynchronization therapy in CRT candidates?
Odds Ratio: 0.6 (95% CI 0.4–0.9)
p-value: p=0.012
Baseline left atrial size is an independent predictor of left ventricular reverse remodeling following cardiac resynchronization therapy, highlighting its potential utility in patient selection and risk stratification.
Aim: Response to cardiac resynchronization therapy varies significantly among patients, with one third of them failing to demonstrate left ventricular reverse remodeling after cardiac resynchronization therapy. Left atrial size and function is increasingly recognized as a marker of disease severity in the heart failure population. The aim of this study was to evaluate whether echocardiographic left atrial indices predict left ventricular reverse remodeling after cardiac resynchronization therapy. Materials and methods: Ninety-nine cardiac resynchronization therapy candidates were prospectively included in the study and underwent echocardiography before and 3-months after cardiac resynchronization therapy implantation. Cardiac resynchronization therapy response was defined as a 15% relative reduction in left ventricular end-systolic volume. Indexed left atrial volume, left atrial reservoir strain, left ventricular end-diastolic volume, and left ventricular ejection fraction along with other known predictors of cardiac resynchronization therapy response (gender, etiology of heart failure, presence of typical left bundle branch block pattern, QRS duration >150 ms) were included in a multivariate logistic regression model to identify predictors for cardiac resynchronization therapy response. Results: = 0.012) remained the only significant predictors for cardiac resynchronization therapy response after three months. None of the baseline left ventricular parameters showed an independent predictive value. Conclusion: Left atrial size at baseline is an independent predictor and is inversely proportional to left ventricular volumetric reverse remodeling in cardiac resynchronization therapy candidates.
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Bouwmeester et al. (2022) conducted an observational in Systolic heart failure (n=99). Left atrial volume index (LAVI) was evaluated on Left ventricular reverse remodeling (≥15% relative reduction in left ventricular end-systolic volume) (OR 0.6, 95% CI 0.4-0.9, p=0.012). Baseline left atrial volume index is an independent predictor of left ventricular reverse remodeling 3 months after cardiac resynchronization therapy, with higher volumes reducing the odds of response (OR 0.6 per 10 mL/m2 increase).
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