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Predictors of Acute Response to Cardiac Resynchronization Therapy in Cardiomyopathy Patients

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Article Type Research Article
Subject Medicine Group
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Amirhassan Shafaatpour, Hakimeh Sadeghian*, Ali Kazemisaied, Masoumeh Lotfi Tokaldany and Arash Jalali
Issue: Volume3-Issue9
Pages: 1130-1138
Received: 2022-09-27
Accepted: 2022-09-30
Published: 2022-09-30

Abstract

Background: Usefulness of echocardiogram-associated markers for prediction of the response of the patients with cardiomyopathy to Cardiac Resynchronization Therapy (CRT) is under debate.

Method: In a cross sectional retrospective design, we analyzed data from 69 cardiomyopathy patients (mean age = 57.59 ± 11.17 years, 69.6% male) with New-York-Heart-Association class ≥ III, left ventricular ejection fraction (LVEF) ≤ 35%, and QRS duration > 120 ms who underwent CRT. Transthoracic echocardiography and tissue Doppler imaging were performed before CRT and transthoracic echocardiography was repeated after CRT. More than 5% increase in the LVEF within 48 hours post CRT was considered as acute response.

Results: After CRT, 36 (52.2%) patients were acute responders. Before CRT, responders had a remarkably higher frequency of diabetes mellitus (36.1% vs.15.2%, p = 0.048), lower left ventricular end systolic volume (125.82 ± 179.73 vs. 179.73 ± 77.51 ml, p = 0.002) and end diastolic volume (165.03 ± 67.09 vs. 236.06 ± 93.24 ml, p < 0.001) compared to none responders. Other echocardiography characteristics were not significantly different. In multivariable analysis, left ventricular end systolic volume remained the sole independent predictor of acute response. A cut-off of 135 ml for left ventricular end systolic volume had a good sensitivity (67.65%) and specificity (72.73%) to distinguish responders from non-responders.

Conclusion: More than half of the cardiomyopathy patients had improvement ≥ 5% in LVEF within 48 hours after CRT. No relationship was found between formerly defined pre-CRT echocardiographic dyssynchrony markers and acute response. Left ventricular end systolic volume was the sole independent predictor of acute response and a threshold of 135 ml could discriminate acute responders to CRT.

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© 2022 Shafaatpour A, et al.. Distributed under Creative Commons CC-BY 4.0 Creative CommonsAttribution

How to cite this article

Shafaatpour A, Sadeghian H, Kazemisaied A, Tokaldany ML, Jalali A. Predictors of Acute Response to Cardiac Resynchronization Therapy in Cardiomyopathy Patients. 2022 Sep 30; 3(9): 1130-1138. doi: 10.37871/jbres1567, Article ID: JBRES1567, Available at: https://www.jelsciences.com/articles/jbres1567.pdf

Subject area(s)

Cardiovascular DiseasesClinical Cardiology

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