Document Detail


Decreased likelihood of response to cardiac resynchronization in patients with severe heart failure.
MedLine Citation:
PMID:  20156941     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: We hypothesized that a very advanced stage of dilated cardiomyopathy is associated with lower response to cardiac resynchronization therapy (CRT).
METHODS AND RESULTS: A consecutive cohort of 147 patients was studied before device implantation and at 12 months follow-up. All patients were in NYHA functional class III-IV and had left-ventricular (LV) systolic dysfunction (LV ejection fraction 24 +/- 7%) and a wide QRS (171 +/- 29 ms). A patient who was alive without heart transplantation and had improved by at least 10% in the 6 min walking test at 12 months follow-up was considered a clinical responder. Fifty-four patients (36%) did not respond to CRT (15 cardiac deaths, 4 heart transplantations). Quality of life indicators (>41 points), LV end-diastolic volumes (>200 mL) and mitral regurgitant orifice area (>16 mm(2)) at baseline were independent predictors of response to CRT. Patients were assigned 1 point for each predictive parameter. Patients with higher scores showed a significantly higher likelihood of non-response to CRT (chi(2) = 12 891, P = 0.005).
CONCLUSION: The results show that non-responder patients have a more advanced stage of the disease, which suggests that CRT should be indicated earlier in the disease process.
Authors:
Bàrbara Vidal; Victoria Delgado; Lluís Mont; Sílvia Poyatos; Etelvino Silva; María Angeles Castel; José M Tolosana; Antonio Berruezo; Josep Brugada; Marta Sitges
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of heart failure     Volume:  12     ISSN:  1879-0844     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-16     Completed Date:  2010-06-10     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  283-7     Citation Subset:  IM    
Affiliation:
Thorax Clinic Institute, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Villarroel 136, 08036 Barcelona, Spain.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Pacing, Artificial*
Cohort Studies
Confidence Intervals
Disease Progression
Female
Heart Failure / therapy*,  ultrasonography
Humans
Logistic Models
Male
Multivariate Analysis
Odds Ratio
Quality of Life
Questionnaires
Sensitivity and Specificity
Severity of Illness Index
Time Factors
Treatment Outcome
Ventricular Dysfunction, Left / therapy*,  ultrasonography

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