Left atrial function, a new predictor of response to cardiac resynchronization therapy?
| Autor: | J-Claude Daubert, Erwan Donal, Christophe Leclercq, Damien Feneon, Anne Bernard, Philippe Mabo, Maxime Fournet, Albin Behaghel |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Bundle-Branch Block Cardiac resynchronization therapy Logistic regression Ventricular Function Left Cardiac Resynchronization Therapy Physiology (medical) Internal medicine medicine Humans Cardiac Resynchronization Therapy Devices Heart Atria Aged Heart Failure Ejection fraction Ischemic cardiomyopathy Ventricular Remodeling business.industry Left bundle branch block Odds ratio Middle Aged medicine.disease Echocardiography Doppler Confidence interval Treatment Outcome Echocardiography Heart failure cardiovascular system Cardiology Atrial Function Left Female Cardiomyopathies Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Heart Rhythm. 12:1800-1806 |
| ISSN: | 1547-5271 |
| DOI: | 10.1016/j.hrthm.2015.04.021 |
| Popis: | Background Cardiac resynchronization therapy (CRT) improves left ventricular (LV) function and induces LV remodeling, and it is an established therapy for advanced heart failure with prolonged QRS duration. One third of patients will not benefit from this invasive therapy. Objective The purpose of this study was to evaluate whether left atrial (LA) strain imaging (e) parameters could help in predicting the response in terms of LV reverse remodeling after CRT. Methods A total of 79 patients who underwent CRT were evaluated with echography before implantation. LA function and LV function were assessed with M-mode, 2-dimensional echocardiography, Doppler, tissue Doppler velocity, and e. LV reverse remodeling was defined as a >15% reduction in LV end-systolic volume. Results At 6 months, 54 patients (68%) were responders to CRT. In multivariable logistic regression, LA systolic peak of strain rate (SRA) (odds ratio [OR} 10.5, 95% confidence interval [CI] 1.76–62.1, P = .01), left bundle branch block (OR 6.8, 95% CI 1.06–43.9, P = .04), ischemic cardiomyopathy (OR 3.93, 95% CI 1.07–14.4, P = .04), and LV preejection index (OR 1.03, 95% CI 1.01–1.05, P = .01) were associated with CRT response. With an SRA cutoff of –0.75%, the negative predictive value for predicting CRT response was 0.62. Conclusion This study demonstrated the possible relevance of assessing LA function before CRT. SRA appeared to be a good predictor of CRT response. Integrating this LA function analysis into the multivariable assessment of patient candidates for CRT should be considered. |
| Databáze: | OpenAIRE |
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