A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE Score

Objectives. It is important to identify super-responders who can derive most benefits from cardiac resynchronization therapy (CRT). We aimed to establish a scoring model that can be used for predicting super-response to CRT. Methods. We retrospectively reviewed 387 CRT patients. Multivariate logisti...

Full description

Saved in:
Bibliographic Details
Main Authors: Xi Liu, Yiran Hu, Wei Hua, Shengwen Yang, Min Gu, Hong-Xia Niu, Li-Gang Ding, Jing Wang, Shu Zhang
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Cardiology Research and Practice
Online Access:http://dx.doi.org/10.1155/2020/3856294
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832566212044783616
author Xi Liu
Yiran Hu
Wei Hua
Shengwen Yang
Min Gu
Hong-Xia Niu
Li-Gang Ding
Jing Wang
Shu Zhang
author_facet Xi Liu
Yiran Hu
Wei Hua
Shengwen Yang
Min Gu
Hong-Xia Niu
Li-Gang Ding
Jing Wang
Shu Zhang
author_sort Xi Liu
collection DOAJ
description Objectives. It is important to identify super-responders who can derive most benefits from cardiac resynchronization therapy (CRT). We aimed to establish a scoring model that can be used for predicting super-response to CRT. Methods. We retrospectively reviewed 387 CRT patients. Multivariate logistic regression analysis was performed to identify predictors for super-response (defined as an absolute increase in left ventricular ejection fraction of ≥15% at 6-month follow-up) and to create a score model. Multivariate Cox proportional-hazard regression analysis was conducted to assess associations with the long-term endpoint (defined as cardiac death/heart transplant, heart failure (HF) hospitalization, or all-cause death) across the score categories at follow-up. Results. Among 387 patients, 109 (28.2%) met super-response. In multivariable analysis, 5 independent predictors (QQ-LAE) were identified: prior no fragmented QRS (odds ratio (OR) = 3.10 (1.39, 6.94)), QRS duration ≥170 ms (OR = 2.37 (1.35, 4.12)), left bundle branch block (OR = 2.57 (1.04, 6.37)), left atrial diameter <45 mm (OR = 3.27 (1.81, 5.89)), and left ventricular end-diastolic dimension <75 mm (OR = 4.11 (1.99, 8.48)). One point was attributed to each predictor, and three score categories were identified. The proportion of super-response after 6-month CRT implantation in patients with scores 0–3, 4, and 5 was 14.6%, 40.3%, and 64.1%, respectively (P<0.001). Patients with score 5 had an 88% reduction in the risk of cardiac death/heart transplant (P=0.042), a 71% reduction in the risk of HF hospitalization (P=0.048), and an 89% reduction in the risk of all-cause mortality (P=0.028) compared to patients with scores 0–3. Conclusions. The QQ-LAE score can be used for prediction of super-response to CRT and selection of most suitable patients in clinical practices.
format Article
id doaj-art-6d253b6191cd44d1bc7ec11a6c70edc0
institution Kabale University
issn 2090-8016
2090-0597
language English
publishDate 2020-01-01
publisher Wiley
record_format Article
series Cardiology Research and Practice
spelling doaj-art-6d253b6191cd44d1bc7ec11a6c70edc02025-02-03T01:04:47ZengWileyCardiology Research and Practice2090-80162090-05972020-01-01202010.1155/2020/38562943856294A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE ScoreXi Liu0Yiran Hu1Wei Hua2Shengwen Yang3Min Gu4Hong-Xia Niu5Li-Gang Ding6Jing Wang7Shu Zhang8State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, ChinaObjectives. It is important to identify super-responders who can derive most benefits from cardiac resynchronization therapy (CRT). We aimed to establish a scoring model that can be used for predicting super-response to CRT. Methods. We retrospectively reviewed 387 CRT patients. Multivariate logistic regression analysis was performed to identify predictors for super-response (defined as an absolute increase in left ventricular ejection fraction of ≥15% at 6-month follow-up) and to create a score model. Multivariate Cox proportional-hazard regression analysis was conducted to assess associations with the long-term endpoint (defined as cardiac death/heart transplant, heart failure (HF) hospitalization, or all-cause death) across the score categories at follow-up. Results. Among 387 patients, 109 (28.2%) met super-response. In multivariable analysis, 5 independent predictors (QQ-LAE) were identified: prior no fragmented QRS (odds ratio (OR) = 3.10 (1.39, 6.94)), QRS duration ≥170 ms (OR = 2.37 (1.35, 4.12)), left bundle branch block (OR = 2.57 (1.04, 6.37)), left atrial diameter <45 mm (OR = 3.27 (1.81, 5.89)), and left ventricular end-diastolic dimension <75 mm (OR = 4.11 (1.99, 8.48)). One point was attributed to each predictor, and three score categories were identified. The proportion of super-response after 6-month CRT implantation in patients with scores 0–3, 4, and 5 was 14.6%, 40.3%, and 64.1%, respectively (P<0.001). Patients with score 5 had an 88% reduction in the risk of cardiac death/heart transplant (P=0.042), a 71% reduction in the risk of HF hospitalization (P=0.048), and an 89% reduction in the risk of all-cause mortality (P=0.028) compared to patients with scores 0–3. Conclusions. The QQ-LAE score can be used for prediction of super-response to CRT and selection of most suitable patients in clinical practices.http://dx.doi.org/10.1155/2020/3856294
spellingShingle Xi Liu
Yiran Hu
Wei Hua
Shengwen Yang
Min Gu
Hong-Xia Niu
Li-Gang Ding
Jing Wang
Shu Zhang
A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE Score
Cardiology Research and Practice
title A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE Score
title_full A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE Score
title_fullStr A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE Score
title_full_unstemmed A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE Score
title_short A Predictive Model for Super-Response to Cardiac Resynchronization Therapy: The QQ-LAE Score
title_sort predictive model for super response to cardiac resynchronization therapy the qq lae score
url http://dx.doi.org/10.1155/2020/3856294
work_keys_str_mv AT xiliu apredictivemodelforsuperresponsetocardiacresynchronizationtherapytheqqlaescore
AT yiranhu apredictivemodelforsuperresponsetocardiacresynchronizationtherapytheqqlaescore
AT weihua apredictivemodelforsuperresponsetocardiacresynchronizationtherapytheqqlaescore
AT shengwenyang apredictivemodelforsuperresponsetocardiacresynchronizationtherapytheqqlaescore
AT mingu apredictivemodelforsuperresponsetocardiacresynchronizationtherapytheqqlaescore
AT hongxianiu apredictivemodelforsuperresponsetocardiacresynchronizationtherapytheqqlaescore
AT ligangding apredictivemodelforsuperresponsetocardiacresynchronizationtherapytheqqlaescore
AT jingwang apredictivemodelforsuperresponsetocardiacresynchronizationtherapytheqqlaescore
AT shuzhang apredictivemodelforsuperresponsetocardiacresynchronizationtherapytheqqlaescore
AT xiliu predictivemodelforsuperresponsetocardiacresynchronizationtherapytheqqlaescore
AT yiranhu predictivemodelforsuperresponsetocardiacresynchronizationtherapytheqqlaescore
AT weihua predictivemodelforsuperresponsetocardiacresynchronizationtherapytheqqlaescore
AT shengwenyang predictivemodelforsuperresponsetocardiacresynchronizationtherapytheqqlaescore
AT mingu predictivemodelforsuperresponsetocardiacresynchronizationtherapytheqqlaescore
AT hongxianiu predictivemodelforsuperresponsetocardiacresynchronizationtherapytheqqlaescore
AT ligangding predictivemodelforsuperresponsetocardiacresynchronizationtherapytheqqlaescore
AT jingwang predictivemodelforsuperresponsetocardiacresynchronizationtherapytheqqlaescore
AT shuzhang predictivemodelforsuperresponsetocardiacresynchronizationtherapytheqqlaescore