Combination of Left Ventricular End-Diastolic Diameter and QRS Duration Strongly Predicts Good Response to and Prognosis of Cardiac Resynchronization Therapy
Background. Approximately 20–40% of recipients of cardiac resynchronization therapy (CRT) do not respond to it based on the current patient selection criteria. The purpose of this study was to identify baseline parameters that can predict CRT response and to evaluate the effect of those predictive p...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-01-01
|
| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2020/1257578 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849398218199138304 |
|---|---|
| author | Zhinian Guo Xiaoyan Liu Xiaofeng Cheng Chuan Liu Ping Li Yongming He Rongsheng Rao Chun Li Yunlong Chen Yong Zhang Xiaoyu Luo Jiang Wang |
| author_facet | Zhinian Guo Xiaoyan Liu Xiaofeng Cheng Chuan Liu Ping Li Yongming He Rongsheng Rao Chun Li Yunlong Chen Yong Zhang Xiaoyu Luo Jiang Wang |
| author_sort | Zhinian Guo |
| collection | DOAJ |
| description | Background. Approximately 20–40% of recipients of cardiac resynchronization therapy (CRT) do not respond to it based on the current patient selection criteria. The purpose of this study was to identify baseline parameters that can predict CRT response and to evaluate the effect of those predictive parameters on long-term prognosis. Methods. This was a retrospective, nonrandomized, noncontrolled cohort study. Patients who received CRT in our centre were divided into responders and nonresponders by the definition of CRT response (an increase in left ventricular ejection fraction (LVEF) of ≥5% and improvement of ≥1 New York Heart Association (NYHA) class from baseline to the 6-month follow-up). Results. Of the 101 patients, 68 were responders and 33 were nonresponders. Left ventricular end-diastolic diameter (LVEDD; OR: 0.88, 95% CI: 0.81–0.95, P=0.001) and QRS duration (OR: 1.07, 95% CI: 1.04–1.10, P<0.001) were independent predictors of CRT response. The combination of LVEDD and QRS duration was more valuable for predicting CRT response (AUC 0.836; 95% CI: 0.76–0.91; P<0.001). Moreover, the combination of LVEDD ≤ 71 mm and QRS duration ≥ 170 ms had a low incidence of all-cause mortality, HF hospitalisation, and the composite endpoint. In addition, baseline LVEDD had a positive correlation with QRS duration (R=0.199, P=0.046). Responders to CRT had better LV reverse remodeling. Conclusion. The combination of LVEDD and QRS duration provided more robust prediction of CRT response. Moreover, the combination of LVEDD ≤ 71 mm and QRS duration ≥ 170 ms was associated with a low incidence of all-cause mortality, HF hospitalisation, and the composite endpoint. Our results may be useful to provide individualized patient selection for CRT. |
| format | Article |
| id | doaj-art-9ed29b709160404bbe20bfbd1cc00a98 |
| 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-9ed29b709160404bbe20bfbd1cc00a982025-08-20T03:38:40ZengWileyCardiology Research and Practice2090-80162090-05972020-01-01202010.1155/2020/12575781257578Combination of Left Ventricular End-Diastolic Diameter and QRS Duration Strongly Predicts Good Response to and Prognosis of Cardiac Resynchronization TherapyZhinian Guo0Xiaoyan Liu1Xiaofeng Cheng2Chuan Liu3Ping Li4Yongming He5Rongsheng Rao6Chun Li7Yunlong Chen8Yong Zhang9Xiaoyu Luo10Jiang Wang11Institute of Cardiovascular Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), 183 Xinqiao Street, Chongqing 400037, ChinaInstitute of Cardiovascular Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), 183 Xinqiao Street, Chongqing 400037, ChinaInstitute of Cardiovascular Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), 183 Xinqiao Street, Chongqing 400037, ChinaInstitute of Cardiovascular Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), 183 Xinqiao Street, Chongqing 400037, ChinaInstitute of Cardiovascular Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), 183 Xinqiao Street, Chongqing 400037, ChinaInstitute of Cardiovascular Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), 183 Xinqiao Street, Chongqing 400037, ChinaInstitute of Cardiovascular Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), 183 Xinqiao Street, Chongqing 400037, ChinaInstitute of Cardiovascular Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), 183 Xinqiao Street, Chongqing 400037, ChinaInstitute of Cardiovascular Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), 183 Xinqiao Street, Chongqing 400037, ChinaInstitute of Cardiovascular Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), 183 Xinqiao Street, Chongqing 400037, ChinaInstitute of Cardiovascular Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), 183 Xinqiao Street, Chongqing 400037, ChinaInstitute of Cardiovascular Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), 183 Xinqiao Street, Chongqing 400037, ChinaBackground. Approximately 20–40% of recipients of cardiac resynchronization therapy (CRT) do not respond to it based on the current patient selection criteria. The purpose of this study was to identify baseline parameters that can predict CRT response and to evaluate the effect of those predictive parameters on long-term prognosis. Methods. This was a retrospective, nonrandomized, noncontrolled cohort study. Patients who received CRT in our centre were divided into responders and nonresponders by the definition of CRT response (an increase in left ventricular ejection fraction (LVEF) of ≥5% and improvement of ≥1 New York Heart Association (NYHA) class from baseline to the 6-month follow-up). Results. Of the 101 patients, 68 were responders and 33 were nonresponders. Left ventricular end-diastolic diameter (LVEDD; OR: 0.88, 95% CI: 0.81–0.95, P=0.001) and QRS duration (OR: 1.07, 95% CI: 1.04–1.10, P<0.001) were independent predictors of CRT response. The combination of LVEDD and QRS duration was more valuable for predicting CRT response (AUC 0.836; 95% CI: 0.76–0.91; P<0.001). Moreover, the combination of LVEDD ≤ 71 mm and QRS duration ≥ 170 ms had a low incidence of all-cause mortality, HF hospitalisation, and the composite endpoint. In addition, baseline LVEDD had a positive correlation with QRS duration (R=0.199, P=0.046). Responders to CRT had better LV reverse remodeling. Conclusion. The combination of LVEDD and QRS duration provided more robust prediction of CRT response. Moreover, the combination of LVEDD ≤ 71 mm and QRS duration ≥ 170 ms was associated with a low incidence of all-cause mortality, HF hospitalisation, and the composite endpoint. Our results may be useful to provide individualized patient selection for CRT.http://dx.doi.org/10.1155/2020/1257578 |
| spellingShingle | Zhinian Guo Xiaoyan Liu Xiaofeng Cheng Chuan Liu Ping Li Yongming He Rongsheng Rao Chun Li Yunlong Chen Yong Zhang Xiaoyu Luo Jiang Wang Combination of Left Ventricular End-Diastolic Diameter and QRS Duration Strongly Predicts Good Response to and Prognosis of Cardiac Resynchronization Therapy Cardiology Research and Practice |
| title | Combination of Left Ventricular End-Diastolic Diameter and QRS Duration Strongly Predicts Good Response to and Prognosis of Cardiac Resynchronization Therapy |
| title_full | Combination of Left Ventricular End-Diastolic Diameter and QRS Duration Strongly Predicts Good Response to and Prognosis of Cardiac Resynchronization Therapy |
| title_fullStr | Combination of Left Ventricular End-Diastolic Diameter and QRS Duration Strongly Predicts Good Response to and Prognosis of Cardiac Resynchronization Therapy |
| title_full_unstemmed | Combination of Left Ventricular End-Diastolic Diameter and QRS Duration Strongly Predicts Good Response to and Prognosis of Cardiac Resynchronization Therapy |
| title_short | Combination of Left Ventricular End-Diastolic Diameter and QRS Duration Strongly Predicts Good Response to and Prognosis of Cardiac Resynchronization Therapy |
| title_sort | combination of left ventricular end diastolic diameter and qrs duration strongly predicts good response to and prognosis of cardiac resynchronization therapy |
| url | http://dx.doi.org/10.1155/2020/1257578 |
| work_keys_str_mv | AT zhinianguo combinationofleftventricularenddiastolicdiameterandqrsdurationstronglypredictsgoodresponsetoandprognosisofcardiacresynchronizationtherapy AT xiaoyanliu combinationofleftventricularenddiastolicdiameterandqrsdurationstronglypredictsgoodresponsetoandprognosisofcardiacresynchronizationtherapy AT xiaofengcheng combinationofleftventricularenddiastolicdiameterandqrsdurationstronglypredictsgoodresponsetoandprognosisofcardiacresynchronizationtherapy AT chuanliu combinationofleftventricularenddiastolicdiameterandqrsdurationstronglypredictsgoodresponsetoandprognosisofcardiacresynchronizationtherapy AT pingli combinationofleftventricularenddiastolicdiameterandqrsdurationstronglypredictsgoodresponsetoandprognosisofcardiacresynchronizationtherapy AT yongminghe combinationofleftventricularenddiastolicdiameterandqrsdurationstronglypredictsgoodresponsetoandprognosisofcardiacresynchronizationtherapy AT rongshengrao combinationofleftventricularenddiastolicdiameterandqrsdurationstronglypredictsgoodresponsetoandprognosisofcardiacresynchronizationtherapy AT chunli combinationofleftventricularenddiastolicdiameterandqrsdurationstronglypredictsgoodresponsetoandprognosisofcardiacresynchronizationtherapy AT yunlongchen combinationofleftventricularenddiastolicdiameterandqrsdurationstronglypredictsgoodresponsetoandprognosisofcardiacresynchronizationtherapy AT yongzhang combinationofleftventricularenddiastolicdiameterandqrsdurationstronglypredictsgoodresponsetoandprognosisofcardiacresynchronizationtherapy AT xiaoyuluo combinationofleftventricularenddiastolicdiameterandqrsdurationstronglypredictsgoodresponsetoandprognosisofcardiacresynchronizationtherapy AT jiangwang combinationofleftventricularenddiastolicdiameterandqrsdurationstronglypredictsgoodresponsetoandprognosisofcardiacresynchronizationtherapy |