Heart failure & cardiomyopathiesCohort study
Dyssynchrony and Response to Cardiac Resynchronization Therapy in Heart Failure Patients With Unfavorable Electrical Characteristics
- Prospective cohort study
Authors' conclusion
In patients with UEC, echocardiographic assessment of EMD may help to select patients who will derive benefit from CRT.
Study context
- Population
- Heart failure (HF) patients receiving cardiac resynchronization therapy (CRT) with unfavorable electrical characteristics (atypical LBBB, RBBB or unspecified intraventricular conduction disturbance)of 551 receiving CRT
- Participants
- 121 patients
- Exposure
- Echocardiographic electromechanical dyssynchrony (EMD) indices vs CRT response and outcome
- Outcome
- CRT response (relative decrease in LV end-systolic volume ≥15%); all-cause death or HF hospitalization
- Follow-up
- 9-month (response)
Main finding
As reported in the abstract
CRT response · 9 months
Adjusted odds ratio (95% CI)P value
GWW ≥200 mm Hg%
4.17(1.33–14.56)
P = 0.0182Longitudinal strain septal contraction patterns 1 and 2
10.05(2.82–43.97)
P < 0.001- CRT responders
- 68 (56%)
Observational data: associations, not effects.
Further findings
Death or HF hospitalization, by number of positive EMD criteria · 46-month follow-up (IQR: 42-55 months)
| Comparison | 2 criteria | 1 criterion | 0 criteria | adjusted HR (95% CI) | P value | |
|---|---|---|---|---|---|---|
| absence of either of the 2 criteria · adjusted for established predictors of outcome after CRT | 87% | 59% | 27% | 4.83 (1.84–12.68) | P = 0.001 | |
| 0.050.21520Adjusted hazard ratio (log scale) |
- Death or HF hospitalization, by number of positive EMD criteria: per-group values = survival free from death or HF hospitalization
Original publication
Dyssynchrony and Response to Cardiac Resynchronization Therapy in Heart Failure Patients With Unfavorable Electrical Characteristics. JACC Cardiovasc Imaging. Published 8 March 2023. doi:10.1016/j.jcmg.2022.12.023
Summarised from the published abstract; every number is checked against it