Document Detail


Results of the SCART study: selection of candidates for cardiac resynchronisation therapy.
MedLine Citation:
PMID:  17906473     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To prospectively determine whether prespecified electrocardiographic, echocardiographic and tissue Doppler imaging (TDI) selection criteria may predict a positive response to cardiac resynchronisation therapy (CRT). METHODS: In this multicentre, prospective, non-randomised study, 96 heart failure patients with New York Heart Association class III-IV symptoms, an ejection fraction of < or =35%, and at least one marker of ventricular dyssynchrony according to prespecified electrocardiographic, echocardiographic or TDI criteria were enrolled. The primary endpoint was an improvement in the clinical composite score at 6 months. RESULTS: At enrolment, 70 patients fulfilled the electrocardiographic criterion (QRS duration > or =150 ms), 77 patients showed echocardiographic signs of dyssynchrony, and 37 patients met the TDI dyssynchrony criteria. The overall responder rate was 78/96 (81%). In particular, the primary endpoint was reached in 68 patients who fulfilled the echocardiographic criteria as compared with 10 patients who did not (88 vs. 53%, P = 0.001). The patients who met the echocardiographic criteria showed a significant greater reduction in left ventricular end-systolic diameter (P = 0.029) and a higher improvement in quality of life (P = 0.017) than patients who did not. Neither electrocardiographic nor TDI criteria seemed to predict a positive response to CRT. CONCLUSIONS: In our patient population, mechanical indexes of dyssynchrony as assessed by echocardiography appeared to identify CRT responders. Although TDI is useful for evaluating ventricular dyssynchrony after CRT, the prespecified TDI inclusion criteria adopted in this investigation did not increase the number of CRT responders.
Authors:
Carlo Peraldo; Augusto Achilli; Serafino Orazi; Stefano Bianchi; Massimo Sassara; Francesco Laurenzi; Antonio Cesario; Gerardina Fratianni; Ernesto Lombardo; Sergio Valsecchi; Alessandra Denaro; Andrea Puglisi
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study    
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  8     ISSN:  1558-2027     ISO Abbreviation:  J Cardiovasc Med (Hagerstown)     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-01     Completed Date:  2008-02-04     Revised Date:  2009-05-28    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  889-95     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Fatebenefratelli Hospital, Isola Tiberina 39, Rome, Italy. c.p.neja@tiscali.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Pacing, Artificial*
Echocardiography, Doppler
Female
Heart Failure / complications,  therapy*
Humans
Male
Patient Selection*
Prospective Studies
Stroke Volume
Ventricular Dysfunction, Left / complications,  ultrasonography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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