Document Detail


Septal to posterior wall motion delay fails to predict reverse remodeling or clinical improvement in patients undergoing cardiac resynchronization therapy.
MedLine Citation:
PMID:  16360048     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to test the hypothesis that a longer septal-to-posterior wall motion delay (SPWMD) would predict greater reverse remodeling and an improved clinical response in heart failure patients randomized to cardiac resynchronization therapy (CRT) in the CONTAK-CD trial. BACKGROUND: The SPWMD predicted clinical benefit with CRT in two previous studies from the same center. METHODS: In this retrospective analysis of the CONTAK-CD trial, SPWMD was measured from the baseline echocardiogram of 79 heart failure patients (ejection fraction 22 +/- 7%, QRS duration 159 +/- 27 ms, 72% ischemic, 84% male) randomized to CRT and compared with six-month changes in echocardiographic and clinical parameters. Patients with a left ventricular end-systolic volume index (LVESVI) reduction of at least 15% were considered responders. RESULTS: The feasibility and reproducibility of performing the SPWMD measurements were poor. Larger values for SPWMD did not correlate with six-month changes in left ventricular end-diastolic volume index (p = 0.26), LVESVI (p = 0.41), or left ventricular ejection fraction (p = 0.36). Responders did not have a significantly different SPWMD than non-responders (p = 0.26). The SPWMD did not correlate with measures of clinical improvement. At a threshold of SPWMD >130 ms, the test characteristics to predict reverse remodeling or a clinical response were inadequate. CONCLUSIONS: The previous findings that SPWMD predicts reverse remodeling or clinical improvement with CRT were not reproducible in patients randomized in the CONTAK-CD trial.
Authors:
Gregory M Marcus; Emily Rose; Esperanza M Viloria; Jill Schafer; Teresa De Marco; Leslie A Saxon; Elyse Foster;
Related Documents :
20478988 - Hemodynamic improvement in cardiac resynchronization does not require improvement in le...
17084258 - Non-invasive visualization of the cardiac venous system in coronary artery disease pati...
8697828 - The six-minute walk test predicts peak oxygen uptake and survival in patients with adva...
18958268 - Visual lv motion and invasive lvdp/dtmax for selection and optimisation of cardiac resy...
19862668 - Testosterone administration induces protection against global myocardial ischemia.
7808208 - An economic analysis of strategies for the use of contrast media for diagnostic cardiac...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  46     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-12-19     Completed Date:  2006-03-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2208-14     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Division of Cardiology, University of California, San Francisco, San Francisco, California, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Output, Low / complications*,  physiopathology,  therapy*,  ultrasonography
Cardiac Pacing, Artificial*
Echocardiography
Feasibility Studies
Female
Heart Septum / physiopathology
Humans
Male
Middle Aged
Multicenter Studies as Topic
Predictive Value of Tests
Randomized Controlled Trials as Topic
Retrospective Studies
Time Factors
Treatment Outcome
Ventricular Dysfunction, Left / etiology*
Ventricular Remodeling*
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2006 Aug 1;48(3):596-7   [PMID:  16876000 ]

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


Previous Document:  There is plenty of room for cardiac resynchronization therapy devices without back-up defibrillators...
Next Document:  Propagation of onset and peak time of myocardial shortening in time of myocardial shortening in isch...