Association of persistent or worsened echocardiographic dyssynchrony with unfavourable clinical outcomes in heart failure patients with narrow QRS width: a subgroup analysis of the EchoCRT trial

European Heart Journal
John GorcsanFrank Ruschitzka

Abstract

EchoCRT was a randomized trial of cardiac resynchronization therapy (CRT) in severely symptomatic heart failure (HF) patients with narrow QRS width <130 ms, ejection fraction ≤35%, and echocardiographic dyssynchrony. All received CRT implants which were then randomized to CRT-On or CRT-Off. While the trial showed no benefit of CRT to these patients, the aim of this subgroup analysis was to test the hypothesis that persistent or worsening dyssynchrony is associated with unfavourable clinical outcomes. We studied 614 EchoCRT patients with baseline and 6-month echocardiograms. Baseline dyssynchrony required for study inclusion was either tissue Doppler imaging longitudinal velocity delay ≥80 ms or speckle-tracking radial strain delay ≥130 ms. Persistent dyssynchrony at 6 months was observed similarly in both groups (77% in CRT-On; 76% in CRT-Off). Persistent dyssynchrony was associated with a significantly higher primary end point of death or HF hospitalization (HR = 1.54, 95% CI 1.03-2.30, P = 0.03), and in particular secondary endpoint of HF hospitalization (HR = 1.66, 95% CI 1.07-2.57, P = 0.02). HF hospitalizations were also associated with worsening longitudinal dyssynchrony (HR = 1.45, 95% CI 1.02-2.05, P = 0.037), and worse...Continue Reading

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Citations

Jan 5, 2016·European Heart Journal·Oliver GaemperliJeroen J Bax
Sep 2, 2015·European Heart Journal·Amil M Shah, Scott D Solomon
Dec 30, 2015·European Heart Journal·Thomas F Lüscher
Nov 7, 2015·European Heart Journal·Fabrizio MontecuccoThomas H Schindler
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Sep 22, 2018·Echocardiography·Federico Vancheri, Michael Henein
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Mar 23, 2017·European Journal of Heart Failure·Tor Biering-SørensenAmil M Shah
Sep 28, 2017·European Heart Journal Cardiovascular Imaging·Ivan StankovicJens-Uwe Voigt
Nov 20, 2016·European Journal of Heart Failure·Matthias P NägeleFrank Ruschitzka
Jan 11, 2017·European Heart Journal·Jedrzej KosiukOle-A Breithardt

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