Measurements of electrical and mechanical dyssynchrony are both essential to improve prediction of CRT response

Journal of Electrocardiology
J Van't SantM Meine

Abstract

Predicting reverse remodeling after cardiac resynchronization therapy (CRT) remains challenging and different etiologies of heart failure might hamper identification of predictors. Assess the incremental value of mechanical dyssynchrony besides electrical dyssynchrony for predicting CRT response. 227 patients (51% ischemic) received CRT. Response was defined as ≥15% left ventricular end systolic volume decrease after six months. Prediction models were developed comprising clinical parameters and electrical dyssynchrony (Model A), subsequently complemented with mechanical dyssynchrony (Model B). Models were compared by area under the receiver-operating curve (AUC), net reclassification index (NRI) and integrated discrimination improvement (IDI) for the complete cohort, ischemic (ICM) and non-ischemic (NICM) subpopulations. Model B performed significantly better than Model A supported by AUC, NRI and IDI. Furthermore, model B significantly better predicted response for NICM than ICM. Electrical dyssynchrony and mechanical dyssynchrony are essential to predict CRT response. Nevertheless, response prediction for ICM remains challenging.

References

Apr 16, 1998·Magnetic Resonance in Medicine : Official Journal of the Society of Magnetic Resonance in Medicine·E R McVeighW C Hunter
Aug 2, 2003·Lancet·James A de LemosMark H Drazner
Nov 3, 2004·Journal of the American College of Cardiology·Jeroen J BaxMartin J Schalij
Apr 21, 2006·Journal of Cardiac Failure·Thomas P CappolaMartin St John Sutton
May 25, 2006·Journal of Cardiovascular Medicine·Lori B Daniels, Alan Maisel
May 7, 2008·Circulation·Eugene S ChungJaime Murillo
Oct 28, 2009·Circulation·Martin St John SuttonUNKNOWN REsynchronization reVErses Remodeling in Systolic left vEntricular dysfunction (REVERSE) Study Group
Jun 22, 2010·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Margot D BogaardMathias Meine
Nov 26, 2010·Heart Failure Reviews·Frits W PrinzenTammo Delhaas
Mar 8, 2011·The American Journal of Cardiology·David G StraussGalen S Wagner
May 5, 2012·Journal of Cardiac Failure·Geert E LeendersMaarten J Cramer
Jun 28, 2012·Journal of Cardiovascular Electrophysiology·Margot D BogaardAnton E Tuinenburg
Jun 27, 2013·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·UNKNOWN European Society of Cardiology (ESC)Panos E Vardas
Sep 4, 2013·The New England Journal of Medicine·Frank RuschitzkaUNKNOWN EchoCRT Study Group

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Citations

Dec 10, 2015·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·W M van EverdingenM J Cramer
Jul 24, 2020·European Heart Journal Cardiovascular Imaging·Odette A E SaldenMaarten J Cramer
Oct 20, 2017·Cardiovascular Ultrasound·Wouter M van EverdingenMaarten J Cramer
Nov 6, 2020·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Yanli ZhouWeihua Zhou

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