Limits...
Predictors of positive response to cardiac resynchronization therapy.

Rinkuniene D, Bucyte S, Ceseviciute K, Abramavicius S, Baronaite-Dudoniene K, Laukaitiene J, Kazakevicius T, Zabiela V, Sileikis V, Puodziukynas A, Jurkevicius R - BMC Cardiovasc Disord (2014)

Bottom Line: A p value < 0.05 was considered statistically significant.Lower uric acid concentration was associated with better echocardiographic response (OR 0.99; 95% CI 0.99 - 1.0, p = 0.01).Smaller left ventricular end-diastolic and end-systolic diameters and lower serum uric acid concentration were associated with better response to CRT.

View Article: PubMed Central - HTML - PubMed

Affiliation: Lithuanian University of Health Sciences, Kaunas, Lithuania. diana.rinkuniene@gmail.com.

ABSTRACT

Background: Approximately 30% of patients treated with cardiac resynchronization therapy (CRT) do not achieve favourable response. The purpose of the present study was to identify echocardiographic and clinical predictors of a positive response to CRT.

Methods: The study included 82 consecutive heart failure (HF) patients in New York Heart Association (NYHA) functional class III or IV with left bundle branch block (LBBB), QRS duration ≥ 120 ms and left ventricular ejection fraction (LVEF) ≤ 35%. Statistical analysis was performed using IBM SPSS statistical software (SPSS v.21.0 for Mac OS X). A p value < 0.05 was considered statistically significant.

Results: Echocardiographic response was established in 81.6% and clinical response was achieved in 82.9% of patients. Significant univariate predictors of favourable echocardiographic response after 12 months were smaller left ventricular end-diastolic diameter (LVEDD) (odds ratio [OR] 0.89; 95% confidence interval [CI] 0.82 - 0.97, p = 0.01), and smaller left ventricular end-systolic diameter (LVESD) (OR 0.91; 95% CI 0.85 - 0.98, p = 0.01). Lower uric acid concentration was associated with better echocardiographic response (OR 0.99; 95% CI 0.99 - 1.0, p = 0.01). Non-ischemic HF etiology (OR 4.89; 95% CI 1.39 - 17.15, p = 0.01) independently predicted positive clinical response. Multiple stepwise regression analysis demonstrated that LVEDD lower than 75 mm (OR 5.60; 95% confidence interval [CI] 1.36 - 18.61, p = 0.01) was the strongest independent predictor of favourable echocardiographic response.

Conclusions: Smaller left ventricular end-diastolic and end-systolic diameters and lower serum uric acid concentration were associated with better response to CRT. Left ventricular end-diastolic diameter and non-ischemic heart failure etiology were the strongest independent predictors of positive response to CRT.

Show MeSH

Related in: MedlinePlus

Distribution of NYHA functional classes at baseline and after 12 months of CRT implantation (p = 0.001). NYHA - New York Heart Association.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4016658&req=5

Figure 2: Distribution of NYHA functional classes at baseline and after 12 months of CRT implantation (p = 0.001). NYHA - New York Heart Association.

Mentions: At 12 months follow-up 54 (71.1%) of patients had a significant improvement in NYHA class (p < 0.001). Distribution of NYHA class at baseline and after 12 months post CRT implantation is provided in Figure 2. An increase in 6-MWT by ≥ 15% was observed in 57 (75%) patients (p = 0.001). Mean increase in 6-MWT post CRT was 121.2 ± 66.1 m in clinical responders and 11.3 ± 27 m in non-responders (p = 0.001). Combined clinical response (improvement in NYHA class ≥ 1 class and/or ≥ 15% increase in the 6-MWT) was achieved in 63 (82.9%) patients (Table 2).


Predictors of positive response to cardiac resynchronization therapy.

Rinkuniene D, Bucyte S, Ceseviciute K, Abramavicius S, Baronaite-Dudoniene K, Laukaitiene J, Kazakevicius T, Zabiela V, Sileikis V, Puodziukynas A, Jurkevicius R - BMC Cardiovasc Disord (2014)

Distribution of NYHA functional classes at baseline and after 12 months of CRT implantation (p = 0.001). NYHA - New York Heart Association.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4016658&req=5

Figure 2: Distribution of NYHA functional classes at baseline and after 12 months of CRT implantation (p = 0.001). NYHA - New York Heart Association.
Mentions: At 12 months follow-up 54 (71.1%) of patients had a significant improvement in NYHA class (p < 0.001). Distribution of NYHA class at baseline and after 12 months post CRT implantation is provided in Figure 2. An increase in 6-MWT by ≥ 15% was observed in 57 (75%) patients (p = 0.001). Mean increase in 6-MWT post CRT was 121.2 ± 66.1 m in clinical responders and 11.3 ± 27 m in non-responders (p = 0.001). Combined clinical response (improvement in NYHA class ≥ 1 class and/or ≥ 15% increase in the 6-MWT) was achieved in 63 (82.9%) patients (Table 2).

Bottom Line: A p value < 0.05 was considered statistically significant.Lower uric acid concentration was associated with better echocardiographic response (OR 0.99; 95% CI 0.99 - 1.0, p = 0.01).Smaller left ventricular end-diastolic and end-systolic diameters and lower serum uric acid concentration were associated with better response to CRT.

View Article: PubMed Central - HTML - PubMed

Affiliation: Lithuanian University of Health Sciences, Kaunas, Lithuania. diana.rinkuniene@gmail.com.

ABSTRACT

Background: Approximately 30% of patients treated with cardiac resynchronization therapy (CRT) do not achieve favourable response. The purpose of the present study was to identify echocardiographic and clinical predictors of a positive response to CRT.

Methods: The study included 82 consecutive heart failure (HF) patients in New York Heart Association (NYHA) functional class III or IV with left bundle branch block (LBBB), QRS duration ≥ 120 ms and left ventricular ejection fraction (LVEF) ≤ 35%. Statistical analysis was performed using IBM SPSS statistical software (SPSS v.21.0 for Mac OS X). A p value < 0.05 was considered statistically significant.

Results: Echocardiographic response was established in 81.6% and clinical response was achieved in 82.9% of patients. Significant univariate predictors of favourable echocardiographic response after 12 months were smaller left ventricular end-diastolic diameter (LVEDD) (odds ratio [OR] 0.89; 95% confidence interval [CI] 0.82 - 0.97, p = 0.01), and smaller left ventricular end-systolic diameter (LVESD) (OR 0.91; 95% CI 0.85 - 0.98, p = 0.01). Lower uric acid concentration was associated with better echocardiographic response (OR 0.99; 95% CI 0.99 - 1.0, p = 0.01). Non-ischemic HF etiology (OR 4.89; 95% CI 1.39 - 17.15, p = 0.01) independently predicted positive clinical response. Multiple stepwise regression analysis demonstrated that LVEDD lower than 75 mm (OR 5.60; 95% confidence interval [CI] 1.36 - 18.61, p = 0.01) was the strongest independent predictor of favourable echocardiographic response.

Conclusions: Smaller left ventricular end-diastolic and end-systolic diameters and lower serum uric acid concentration were associated with better response to CRT. Left ventricular end-diastolic diameter and non-ischemic heart failure etiology were the strongest independent predictors of positive response to CRT.

Show MeSH
Related in: MedlinePlus