Longer right to left ventricular activation delay at cardiac resynchronization therapy implantation is associated with improved clinical outcome in left bundle branch block patients
| Autor: | Valentina Kutyifa, Béla Merkely, Gábor Széplaki, Szabolcs Szilágyi, Levente Molnár, Vivien Klaudia Nagy, Emin Evren Özcan, Endre Zima, Annamaria Kosztin, László Gellér |
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| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Male
Time Factors medicine.medical_treatment Action Potentials Kaplan-Meier Estimate 030204 cardiovascular system & hematology Ventricular Function Left Cardiac Resynchronization Therapy Electrocardiography 0302 clinical medicine Risk Factors Natriuretic Peptide Brain Clinical endpoint 030212 general & internal medicine Prospective Studies RV-LV activation delay Ejection fraction Left bundle branch block Hazard ratio Middle Aged Pacing and Resynchronization Therapy Treatment Outcome Echocardiography Cardiology Female Cardiology and Cardiovascular Medicine medicine.medical_specialty Heart Ventricles Cardiac resynchronization therapy response Bundle-Branch Block Cardiac resynchronization therapy Lower risk Disease-Free Survival 03 medical and health sciences QRS complex Clinical Research Heart Conduction System Predictive Value of Tests Physiology (medical) Internal medicine medicine Humans Aged Heart Failure business.industry Stroke Volume Recovery of Function medicine.disease Peptide Fragments Heart failure Chronic Disease Clinical response Ventricular Function Right business Biomarkers |
| Zdroj: | Europace |
| ISSN: | 1532-2092 1099-5129 |
| Popis: | Aims Data on longer right to left ventricular activation delay (RV-LV AD) predicting clinical outcome after cardiac resynchronization therapy (CRT) by left bundle branch block (LBBB) are limited. We aimed to evaluate the impact of RV-LV AD on N-terminal pro–B-type natriuretic peptide (NT-proBNP), ejection fraction (EF), and clinical outcome in patients implanted with CRT, stratified by LBBB at baseline. Methods and results Heart failure (HF) patients undergoing CRT implantation with EF ≤ 35% and QRS ≥ 120 ms were evaluated based on their RV-LV AD at implantation. Baseline and 6-month clinical parameters, EF, and NT-proBNP values were assessed. The primary endpoint was HF or death, the secondary endpoint was all-cause mortality. A total of 125 patients with CRT were studied, 62% had LBBB. During the median follow-up of 2.2 years, 44 (35%) patients had HF/death, 36 (29%) patients died. Patients with RV-LV AD ≥ 86 ms (lower quartile) had significantly lower risk of HF/death [hazard ratio (HR): 0.44; 95% confidence interval (95% CI): 0.23–0.82; P = 0.001] and all-cause mortality (HR: 0.48; 95% CI: 0.23–1.00; P = 0.05), compared with those with RV-LV AD < 86 ms. Patients with RV-LV AD ≥ 86 ms and LBBB showed the greatest improvement in EF (28–36%; P |
| Databáze: | OpenAIRE |
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