| Septal to posterior wall motion delay fails to predict reverse remodeling or clinical improvement in patients undergoing cardiac resynchronization therapy. | |
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MedLine Citation:
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PMID: 16360048 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Gregory M Marcus; Emily Rose; Esperanza M Viloria; Jill Schafer; Teresa De Marco; Leslie A Saxon; Elyse Foster; |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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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:
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Created Date: 2005-12-19 Completed Date: 2006-03-02 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 2208-14 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, Division of Cardiology, University of California, San Francisco, San Francisco, California, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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J Am Coll Cardiol. 2006 Aug 1;48(3):596-7
[PMID:
16876000
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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