Traditional Criteria of Mechanical and Electrical Dyssynchrony as a Predictor of Super-Response in Patients with Cardiac Resynchronization Therapy
https://doi.org/10.29001/2073-8552-2022-37-4-124-128
Abstract
Aim: To evaluate clinical and morpho-functional predictors of super-response to cardiac resynchronization therapy (CRT) in patients with heart failure and reduced ejection fraction (HFrEF) in the short-term period after implantation.
Material and Methods. The study enrolled 86 patients (88.4% men, 54.0 ± 8.9 years mean age, New York Heart Association (NYHA) class II–IV). Patients were examined at baseline and in dynamics (mean follow-up was 10.6 ± 3.6 months). According to the change in left ventricular (LV) end-systolic volume (ESV) patients were divided into two groups: Group I (n = 19) with a decrease in LV ESV ≥ 30% (super-responders (SR) and Group II (n = 67) – decrease in LV ESV < 30% (non-super-responders (non-SR). Parameters of mechanical dyssynchrony (MD) were assessed in the two groups including LV pre-ejection period, interventricular mechanical delay (IVMD), intraventricular delay (IVD).
Results. At baseline, traditional parameters of MD were higher in SR: LV pre-ejection period (156.8 ± 35.4 ms vs 135.0 ± 35.6 ms; p = 0.021) and IVMD (73.0 [43.0; 108.0] ms vs 47.0 [19.5; 70.0] ms; p = 0.017). Logistic regression results showed that female gender (HR 7.048; 95% CI 1.496–33.206; p = 0.014) and QRS width (HR 1.017; 95% CI 1.000–1.034; p = 0.048) had an independent association with super-response.
Conclusion. In patients with HFrEF, more severe mechanical and electrical dyssynchrony is associated with super-response to CRT in a short-term follow-up period.
About the Authors
N. E. Shirokov
Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation
Russian Federation
Nikita Е. Shirokov, Cand. Sci. (Med.), Research Scientist of the Laboratory of Instrumental Diagnostics of the Scientific Department of Instrumental Research Methods
111, Melnikaite str., Tyumen, 625026
111, Melnikaite str., Tyumen, 625026
A. M. Soldatova
Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation
Russian Federation
Anna M. Soldatova, Dr. Sci. (Med.), Research Scientist of the Laboratory of Instrumental Diagnostics of the Scientific Department of Instrumental Research Methods, sonographer
111, Melnikaite str., Tyumen, 625026
D. V. Krinochkin
Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation
Russian Federation
Dmitry V. Krinochkin, Cand. Sci. (Med.), Head of the department of ultrasound diagnostics, Senior Research Scientist of the Laboratory of Instrumental Diagnostics of the Scientific Department of Instrumental Research Methods
111, Melnikaite str., Tyumen, 625026
V. A. Kuznetsov
Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation
Russian Federation
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Review
For citations:
Shirokov N.E., Soldatova A.M., Krinochkin D.V., Kuznetsov V.A. Traditional Criteria of Mechanical and Electrical Dyssynchrony as a Predictor of Super-Response in Patients with Cardiac Resynchronization Therapy. Siberian Journal of Clinical and Experimental Medicine. 2022;37(4):124-128. https://doi.org/10.29001/2073-8552-2022-37-4-124-128
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