Electromechanical factors associated with favourable outcome in cardiac resynchronization therapy

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00159816%3A_____%2F23%3A00079788" target="_blank" >RIV/00159816:_____/23:00079788 - isvavai.cz</a>

Result on the web

<a href="https://academic.oup.com/europace/article/25/2/546/6699319" target="_blank" >https://academic.oup.com/europace/article/25/2/546/6699319</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1093/europace/euac157" target="_blank" >10.1093/europace/euac157</a>

Result language

angličtina

Original language name

Electromechanical factors associated with favourable outcome in cardiac resynchronization therapy

Original language description

Aims Electromechanical coupling in patients receiving cardiac resynchronization therapy (CRT) is not fully understood. Our aim was to determine the best combination of electrical and mechanical substrates associated with effective CRT. Methods and results Sixty-two patients were prospectively enrolled from two centres. Patients underwent 12-lead electrocardiogram (ECG), cardiovascular magnetic resonance (CMR), echocardiography, and anatomo-electromechanical mapping (AEMM). Remodelling was measured as the end-systolic volume (Delta ESV) decrease at 6 months. CRT was defined effective with Delta ESV &lt;= -15%. QRS duration (QRSd) was measured from ECG. Area strain was obtained from AEMM and used to derive systolic stretch index (SSI) and total left-ventricular mechanical time. Total left-ventricular activation time (TLVAT) and transeptal time (TST) were derived from AEMM and ECG. Scar was measured from CMR. Significant correlations were observed between Delta ESV and TST [rho = 0.42; responder: 50 (20-58) vs. non-responder: 33 (8-44) ms], TLVAT [-0.68; 81 (73-97) vs. 112 (96-127) ms], scar [-0.27; 0.0 (0.0-1.2) vs. 8.7 (0.0-19.1)%], and SSI [0.41; 10.7 (7.1-16.8) vs. 4.2 (2.9-5.5)], but not QRSd [-0.13; 155 (140-176) vs. 167 (155-177) ms]. TLVAT and SSI were highly accurate in identifying CRT response [area under the curve (AUC) &gt; 0.80], followed by scar (AUC &gt; 0.70). Total left-ventricular activation time (odds ratio = 0.91), scar (0.94), and SSI (1.29) were independent factors associated with effective CRT. Subjects with SSI &gt;7.9% and TLVAT &lt;91 ms all responded to CRT with a median Delta ESV approximate to -50%, while low SSI and prolonged TLVAT were more common in non-responders (Delta ESV approximate to -5%). Conclusion Electromechanical measurements are better associated with CRT response than conventional ECG variables. The absence of scar combined with high SSI and low TLVAT ensures effectiveness of CRT.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

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Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2023

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Europace

ISSN

1099-5129

e-ISSN

1532-2092

Volume of the periodical

25

Issue of the periodical within the volume

2

Country of publishing house

US - UNITED STATES

Number of pages

8

Pages from-to

546-553

UT code for WoS article

000853949200001

EID of the result in the Scopus database

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