Key result
∆LVESV reliably predicts MACE in non-ischaemic cardiomyopathy, showing an AUC of ~0.85, but fails in ischaemic disease.
Why the study?
It is uncertain whether change in left ventricular end-systolic volume (∆LVESV) is the best surrogate marker to discriminate CRT response and if this applies equally to non-ischaemic and ischaemic cardiomyopathy.
Does change in left ventricular end-systolic volume (∆LVESV) best predict major adverse cardiac events in patients receiving cardiac resynchronisation therapy?
Cohort (n=205)
No
Does change in left ventricular end-systolic volume (∆LVESV) best predict major adverse cardiac events in patients receiving cardiac resynchronisation therapy?
Hazard Ratio: 0.975 (95% CI 0.96–0.991)
Change in LVESV is a strong surrogate marker for long-term outcomes after CRT in non-ischaemic cardiomyopathy, but not in ischaemic cardiomyopathy where change in BNP performs better.
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∆LVESV may inform surrogate selection after CRT in non-ischaemic cardiomyopathy; hypothesis-generating and requires prospective validation before clinical adoption, especially in ischaemic disease.
Sant et al. (2015) conducted a cohort in Heart failure requiring cardiac resynchronisation therapy (n=205). Change in left ventricular end-systolic volume (∆LVESV) was evaluated on Major adverse cardiac events (MACE) between 6 and 24 months (HR 0.975, 95% CI 0.960-0.991). Change in left ventricular end-systolic volume (∆LVESV) was a reliable surrogate marker for major adverse cardiac events in non-ischaemic cardiomyopathy (AUC 0.85) but not in ischaemic cardiomyopathy.
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