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A patient selection score for cardiac resynchronization therapy.
MedLine Citation:
PMID:  21276075     Owner:  NLM     Status:  In-Data-Review    
Background: We hypothesized a patient selection score (PSS) may improve patient selection for cardiac resynchronization therapy (CRT). Methods: Of 136 patients who received CRT, group A included 100 study patients and group B 36 patients for validation. A positive response to CRT was a left ventricular (LV) end-systolic volume decrease of ≥15% and survival from heart failure at end of follow-up. Results: Of 100 group A patients, 37 (37%) were CRT responders during 14-month follow-up. A 7-point PSS was generated based on six variables. The cutoff point for PSS to predict a positive response to CRT was >4 by receiver operating characteristic (ROC) analysis. The area under the ROC curve (AUC) for PSS to predict CRT response was 0.94 (P = 0.0001). CRT responders in patients with a PSS > 4 and ≤4 were 33/40 (83%), and 4/60 (7%), respectively (P < 0.001). Multivariate Cox proportional regression analysis showed that PSS was related to CRT response (hazard ratio = 10.3, P < 0.0001). The CRT response rate in patients with a PSS > 4 in Group B was also significantly higher compared to a PSS ≤ 4 (88% vs. 16%, P < 0.001). The AUC for PSS to predict a CRT response in Group B was 0.91 (P = 0.0001). Conclusions: Patients with a PSS >4 are the most likely to respond to CRT. Using this score system, a PSS score >4 can predict the probability of a CRT response up to 88% in patients with heart failure and a wide QRS duration. (Echocardiography 2011;28:188-195).
Xuedong Shen; Chandra K Nair; Wilbert S Aronow; Tom Hee; Suman Pasupuleti; Mark J Holmberg; Fenwei Wang; Dennis J Esterbrooks
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  28     ISSN:  1540-8175     ISO Abbreviation:  Echocardiography     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  188-95     Citation Subset:  IM    
Copyright Information:
© 2011, Wiley Periodicals, Inc.
Cardiac Center of Creighton University School of Medicine, Valhalla, New York; and †Omaha, Nebraska, and the Cardiology Division, Department of Medicine, New York Medical College, Valhalla, New York.
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