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

Kód výsledku v 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>

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

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

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

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

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2021

Kód důvěrnosti údajů

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

Název periodika

Journal of Cardiovascular Electrophysiology

ISSN

1045-3873

e-ISSN

1540-8167

Svazek periodika

32

Číslo periodika v rámci svazku

3

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

10

Strana od-do

813-822

Kód UT WoS článku

000612475500001

EID výsledku v databázi Scopus

2-s2.0-85099840874