scholarly journals Heart Failure Duration Combined with Left Atrial Dimension Predicts Super-Response and Long-Term Prognosis in Patients with Cardiac Resynchronization Therapy Implantation

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Zhinian Guo ◽  
Xiaoyan Liu ◽  
Chuan Liu ◽  
Jie Yang ◽  
Xiaofeng Cheng ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Left Atrial ◽  
Cardiac Resynchronization ◽  
Reverse Remodeling ◽  
Resynchronization Therapy ◽  
End Point ◽  
Long Term Prognosis ◽  
Robust Prediction

Background. Response to cardiac resynchronization therapy (CRT) varies significantly among patients. This study aimed to identify baseline characteristics that could predict super-response to CRT and to evaluate the long-term prognosis in super-responders. Methods. We retrospectively reviewed the data of 73 consecutive patients who received CRT. Patients were considered as super-responders after 6-month follow-up when NYHA class reduction to I or II combined with left ventricular ejection fraction (LVEF) ≥ 50% was observed. Patients were divided into super-responders group and non-super-responders group. All-cause mortality or hospitalization for heart failure (HF) was referred to the combined end point. Results. 17 (23.3%) patients were super-responders. HF duration, left atrial dimension (LAD), and left bundle branch block (LBBB) were independent predictors of super-response to CRT. The combination of HF duration and LAD could provide more robust prediction of super-response than standalone HF duration (0.899 versus 0.789, Z = 2.207, P = 0.027) or standalone LAD (0.899 versus 0.775, Z = 2.487, P = 0.013). super-responders had excellent LV reverse remodeling. The cumulative incidences of combined end point were significantly lower in the super-responders group, LAD ≤ 42mm group, and combination of HF duration ≤ 48 months and LAD ≤ 42mm group. LBBB remained associated with a lowered risk of the combined end point (HR: 0.19, 95% CI: 0.07-0.57, P = 0.003), whereas LAD was associated with a raised risk of the combined end point (HR: 1.09, 95% CI: 1.02-1.17, P = 0.014). Conclusions. HF duration, LAD, and LBBB independently predicted super-response. The combination of HF duration and LAD makes more robust prediction of CRT super-response. Super-responders had excellent LV reverse remodeling and decreased the incidences of the combined end point. LBBB and LAD were independently associated with the combined end point.

Left atrial reverse remodeling predicts long-term survival after cardiac resynchronization therapy

2021 ◽  
Author(s):  
Sjoerd Bouwmeester ◽  
Thomas P. Mast ◽  
Daniëlle C. J. Keulards ◽  
Anouk G. W. de Lepper ◽  
Ingeborg H. F. Herold ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Left Atrial ◽  
Cardiac Resynchronization ◽  
Reverse Remodeling ◽  
Resynchronization Therapy ◽  
Term Survival ◽  
Long Term Survival ◽  
Atrial Reverse Remodeling

scholarly journals Cardiac resynchronization therapy in a patient with noncompaction of ventricular myocardium: a case report

2021 ◽  
Author(s):  
Juan Wang ◽  
Dasheng Lu ◽  
Yunong Han ◽  
Hongxiang zhang
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Ventricular Myocardium ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Bundle Branch Block ◽  
Noncompaction Of Ventricular Myocardium ◽  
Patients With Heart Failure ◽  
Long Term Prognosis

Noncompaction of ventricular myocardium (NVM) is a rare and specific type of congenital cardiomyopathy that occurs in only 0.05% in adults. Cardiac resynchronization therapy (CRT) improves cardiac function and long-term prognosis in patients with heart failure with left bundle branch block, but its efficacy on NVM is uncertain

Left ventricular volumes at baseline and outcome in heart failure patients undergoing cardiac resynchronization therapy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Kostyukevich ◽  
P Van Der Bijl ◽  
B Mertens ◽  
M Vo ◽  
N.A Marsan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Filtration Rate ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
End Point ◽  
Lv Volumes ◽  
Long Term Prognosis

Abstract Background Studies evaluating the relationship between baseline left ventricular (LV) volumes and long-term prognosis in heart failure (HF) patients undergoing cardiac resynchronization therapy (CRT) are lacking. Purpose To evaluate the association of LV end-systolic and end-diastolic volumes (ESV and EDV) with long-term prognosis in patients with HF treated with CRT. Methods Patients from an ongoing institutional HF registry who received CRT according to contemporary guidelines were included. All patients underwent standard transthoracic echocardiography. LV volumes were measured using the biplane method during off-line analysis. Primary end-point included all-cause mortality, implantation of left ventricular assist device or heart transplantation, which were assessed according to the national death registry and case records. Results In total, 1165 patients with feasible LV volume assessment were included (mean age 67±10 years; 74.8% males; 55.3% with non-ischemic aetiology of HF). After a median follow-up of 75 (40; 123) months, the primary end-point occurred in 708 (60.8%) patients. Median baseline LV ESV was 151 (108; 198) ml and EDV was 202 (156; 258) ml. All patients were divided into quartiles according to the baseline EDV and ESV: those with larger volumes were significantly younger, more frequently male and had longer QRS durations (p<0.001). Heart failure aetiology, glomerular filtration rate, quality of life and 6-minute walking test distance did not differ significantly between the groups (p>0.05). To investigate the association between long-term prognosis and baseline LV volumes (EDV and ESV), a Cox proportional hazards model was constructed with variables known to influence the mortality of HF patients (age, gender, aetiology, QRS duration, and estimated glomerular filtration rate). When separately included in a multivariate analysis, baseline LV ESV and LV EDV were both independently associated with the primary end-point (p<0.001). To demonstrate hazard change across the range of LV ESV and EDV as continuous variables, an adjusted (for covariates influencing HF mortality) spline curve was drawn, showing an increased mortality risk when the baseline LV ESV and EDV are larger than 100 ml and 200 ml, respectively (Figure). Conclusion LV volumes before CRT implantation are independently associated with prognosis during long-term follow-up. Our findings indicate the importance of taking baseline LV remodelling into consideration to identify patients at high mortality risk after CRT implantation. Funding Acknowledgement Type of funding source: Public grant(s) – EU funding. Main funding source(s): The author acknowledges funding received from the European Society of Cardiology in form of an ESC Training Grant

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