Abstract
In this study, the authors sought to assess the impact of body and heart size on sex-specific cardiac resynchronization therapy (CRT) response rate, according to QRS duration (QRSd) as a continuum. Effects of CRT differ between sexes for any given QRSd. New York Heart Association functional class III/IV patients with nonischemic cardiomyopathy and "true" left bundle branch block (LBBB) were evaluated. Left ventricular mass (LVM) and end-diastolic volume were measured echocardiographically. Positive response was defined by left ventricular ejection fraction (LVEF) improvement post-CRT. Among 130 patients (LVEF 19 ± 7.1%; QRSd 165 ± 20 ms; 55% female), CRT improved LVEF to 32 ± 14% (p < 0.001) during a median 2 years follow-up. Positive responses occurred in 103 of 130 (79%) (78% when QRSd <150 ms vs. 80% when QRSd ≥150 ms; p = 0.8). Body surface area (BSA), QRSd, and LVM were lower in women, but QRSd/LVM ratio greater (p < 0.0001). Sexes did not differ for pharmacotherapy and comorbidities, but female CRT response was greater: 90% (65 of 72) versus 66% (38 of 58) in males (p < 0.001). With QRSd as a continuum, the overall CRT-response relationship showed a progressive increase to plateau between 150 and 170 ms, then a decrease. ...Continue Reading
Citations
Mar 29, 2019·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Norman C WangSamir Saba
Aug 14, 2020·ESC Heart Failure·Bruce L WilkoffGerasimos Filippatos
Feb 13, 2018·Journal of the American Heart Association·Niraj VarmaBrian Wisnoskey
May 29, 2018·Journal of the American Heart Association·Niraj VarmaFrank Ruschitzka
Dec 14, 2018·Circulation. Arrhythmia and Electrophysiology·Alwin ZweerinkCornelis P Allaart
Feb 20, 2019·Circulation·Eileen M Hsich
Sep 23, 2018·Current Treatment Options in Cardiovascular Medicine·Daniela R Crousillat, Nasrien E Ibrahim
Oct 9, 2020·Circulation. Arrhythmia and Electrophysiology·Niraj VarmaRaffaele Corbisiero
May 8, 2020·The Canadian Journal of Cardiology·Mohamed Osama MohamedMamas A Mamas
Jul 4, 2020·The Canadian Journal of Cardiology·F Daniel Ramirez
Nov 3, 2020·European Journal of Heart Failure·Wilfried MullensChristophe Leclercq
Mar 16, 2021·Journal of the American Heart Association·Janice Y ChyouCarolyn S P Lam
Mar 16, 2021·Frontiers in Cardiovascular Medicine·Márton TokodiBéla Merkely
Mar 29, 2021·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Hye Bin GwagSeung-Jung Park
May 27, 2021·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·Wilfried MullensChristophe Leclercq
Sep 14, 2021·ESC Heart Failure·Hans Henrik OdlandErik Kongsgard
Sep 10, 2021·Pacing and Clinical Electrophysiology : PACE·Seung-Jung ParkNiraj Varma