Reduction in the QRS area after cardiac resynchronization therapy is associated with survival and echocardiographic response

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F68081731%3A_____%2F21%3A00559945" target="_blank" >RIV/68081731:_____/21:00559945 - isvavai.cz</a>

Result on the web

<a href="https://onlinelibrary.wiley.com/doi/10.1111/jce.14910" target="_blank" >https://onlinelibrary.wiley.com/doi/10.1111/jce.14910</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1111/jce.14910" target="_blank" >10.1111/jce.14910</a>

Result language

angličtina

Original language name

Reduction in the QRS area after cardiac resynchronization therapy is associated with survival and echocardiographic response

Original language description

Introduction: Recent studies have shown that the baseline QRS area is associated with the clinical response after cardiac resynchronization therapy (CRT). In this study, we investigated the association of QRS area reduction (∆QRS area) after CRT with the outcome. We hypothesize that a larger ∆QRS area is associated with a better survival and echocardiographic response.nMethods and Results: Electrocardiograms (ECG) obtained before and 2–12 months after CRT from 1299 patients in a multi-center CRT-registry were analyzed. The QRS area was calculated from vectorcardiograms that were synthesized from 12-lead ECGs. The primary endpoint was a combination of all-cause mortality, heart transplantation, and left ventricular (LV) assist device implantation. The secondary endpoint was the echocardiographic response, defined as LV end-systolic volume reduction ≥ of 15%. Patients with ∆QRS area above the optimal cut-off value (62 µVs) had a lower risk of reaching the primary endpoint (hazard ratio: 0.43, confidence interval [CI] 0.33–0.56, p < .001), and a higher chance of echocardiographic response (odds ratio [OR] 3.3,CI 2.4–4.6, p < .0001). In multivariable analysis, ∆QRS area was independently associated with both endpoints. In patients with baseline QRS area ≥109 µVs, survival, and echocardiographic response were better when the ∆QRS area was ≥62 µVs (p < .0001). Logistic regression showed that in patients with baseline QRS area ≥109 µVs, ∆QRS area was the only significant predictor of survival (OR: 0.981, CI: 0.967–0.994, p = .006).nConclusion: ∆QRS area is an independent determinant of CRT response, especially in patients with a large baseline QRS area. Failure to achieve a large QRS area reduction with CRT is associated with a poor clinical outcome.

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

—

OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2021

Confidentiality

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

Name of the periodical

Journal of Cardiovascular Electrophysiology

ISSN

1045-3873

e-ISSN

1540-8167

Volume of the periodical

32

Issue of the periodical within the volume

3

Country of publishing house

US - UNITED STATES

Number of pages

10

Pages from-to

813-822

UT code for WoS article

000612475500001

EID of the result in the Scopus database

2-s2.0-85099840874