TY - JOUR
T1 - A new baseline scoring system may help to predict response to cardiac resynchronization therapy
AU - Shen, Xuedong
AU - Nair, Chandra K.
AU - Aronow, Wilbert S.
AU - Holmberg, Mak J.
AU - Reddy, Madhu
AU - Anand, Kishley
AU - Hee, Tom
AU - Chen, Aimin
AU - Fang, Xiang
AU - Maciejewski, Stephanie
AU - Esterbrooks, Dennis J.
PY - 2011/8
Y1 - 2011/8
N2 - Introduction: The PROSPECT trial reported no single echocardiographic measurement of dyssynchrony is recommended to improve patient selection for cardiac resynchronization therapy (CRT). Material and methods: In 100 consecutive patients who received CRT, we analyzed 27 ECG and echocardiographic variables to predict a positive response to CRT defined as a left ventricular (LV) end systolic volume decrease of ≥ 15% after CRT. Results: Right ventricular (RV) pacing-induced left bundle branch block (LBBB), time difference between LV ejection measured by tissue Doppler and pulsed wave Doppler (T TDI-PW), and wall motion score index (WMSI) were significantly associated with positive CRT response by multivariate regression. We assigned 1 point for RV pacing-induced LBBB, 1 point for WMSI ≤ 1.59, and 2 points for TTDI-PW > 50 ms. Overall mean response score was 1.79 ±1.39. Cutoff point for response score to predict positive response to CRT was > 2 by receiver operating characteristic (ROC) analysis. Area under ROC curve was 0.97 (p = 0.0001). Cardiac resynchronization therapy responders in patients with response score > 2 and ≤ 2 were 36/38 (95%) and 7/62 (11%, p <0.001), respectively. After age and gender adjustment, the response score was related to CRT response (OR = 45.4, p <0.0001). Conclusions: A response score generated from clinical, ECG and echocardiographic variables may be a useful predictor for CRT response. However, this needs to be validated.
AB - Introduction: The PROSPECT trial reported no single echocardiographic measurement of dyssynchrony is recommended to improve patient selection for cardiac resynchronization therapy (CRT). Material and methods: In 100 consecutive patients who received CRT, we analyzed 27 ECG and echocardiographic variables to predict a positive response to CRT defined as a left ventricular (LV) end systolic volume decrease of ≥ 15% after CRT. Results: Right ventricular (RV) pacing-induced left bundle branch block (LBBB), time difference between LV ejection measured by tissue Doppler and pulsed wave Doppler (T TDI-PW), and wall motion score index (WMSI) were significantly associated with positive CRT response by multivariate regression. We assigned 1 point for RV pacing-induced LBBB, 1 point for WMSI ≤ 1.59, and 2 points for TTDI-PW > 50 ms. Overall mean response score was 1.79 ±1.39. Cutoff point for response score to predict positive response to CRT was > 2 by receiver operating characteristic (ROC) analysis. Area under ROC curve was 0.97 (p = 0.0001). Cardiac resynchronization therapy responders in patients with response score > 2 and ≤ 2 were 36/38 (95%) and 7/62 (11%, p <0.001), respectively. After age and gender adjustment, the response score was related to CRT response (OR = 45.4, p <0.0001). Conclusions: A response score generated from clinical, ECG and echocardiographic variables may be a useful predictor for CRT response. However, this needs to be validated.
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U2 - 10.5114/aoms.2011.24132
DO - 10.5114/aoms.2011.24132
M3 - Article
C2 - 22291798
AN - SCOPUS:80052587963
SN - 1734-1922
VL - 7
SP - 627
EP - 633
JO - Archives of Medical Science
JF - Archives of Medical Science
IS - 4
ER -