Linde, C., Abraham, W. T., Gold, M. R., Daubert, C., Tang, A. S.L., Young, J. B., Sherfesee, L., Hudnall, H., Fagan, D. H. and Cleland, J. G. (2017) Predictors of short-term clinical response to cardiac resynchronization therapy. European Journal of Heart Failure, 19(8), pp. 1056-1063. (doi: 10.1002/ejhf.795) (PMID:28295869)
|
Text
137915.pdf - Accepted Version 2MB |
Abstract
Aims: Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in patients with symptomatic heart failure and QRS prolongation but there is uncertainty about which patient characteristics predict short-term clinical response. Methods and results: In an individual patient meta-analysis of three double-blind, randomized trials, clinical composite score (CCS) at 6 months was compared in patients assigned to CRT programmed on or off. Treatment–covariate interactions were assessed to measure likelihood of improved CCS at 6 months. MIRACLE, MIRACLE ICD, and REVERSE trials contributed data for this analysis (n = 1591). Multivariable modelling identified QRS duration and left ventricular ejection fraction (LVEF) as predictors of CRT clinical response (P < 0.05). The odds ratio for a better CCS at 6 months increased by 3.7% for every 1% decrease in LVEF for patients assigned to CRT-on compared to CRT-off, and was greatest when QRS duration was between 160 and 180 ms. Conclusions: In symptomatic chronic heart failure patients (NYHA class II–IV), longer QRS duration and lower LVEF independently predict early clinical response to CRT.
Item Type: | Articles |
---|---|
Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Cleland, Professor John |
Authors: | Linde, C., Abraham, W. T., Gold, M. R., Daubert, C., Tang, A. S.L., Young, J. B., Sherfesee, L., Hudnall, H., Fagan, D. H., and Cleland, J. G. |
College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre |
Journal Name: | European Journal of Heart Failure |
Publisher: | Wiley |
ISSN: | 1388-9842 |
ISSN (Online): | 1879-0844 |
Published Online: | 14 March 2017 |
Copyright Holders: | Copyright © 2017 The Authors and European Society of Cardiology |
First Published: | First published in European Journal of Heart Failure 19(8): 1056-1063 |
Publisher Policy: | Reproduced in accordance with the publisher copyright policy |
University Staff: Request a correction | Enlighten Editors: Update this record