Heart Failure Duration Combined with Left Atrial Dimension Predicts Super-Response and Long-Term Prognosis in Patients with Cardiac Resynchronization Therapy Implantation.

Content Provider	Europe PMC
Author	Guo, Zhinian Liu, Xiaoyan Liu, Chuan Yang, Jie Cheng, Xiaofeng Chen, Yunlong Li, Ping He, Yongming Wang, Jiang
Copyright Year	2019
Abstract	Background Response to cardiac resynchronization therapy (CRT) varies significantly among patients. This study aimed to identify baseline characteristics that could predict super-response to CRT and to evaluate the long-term prognosis in super-responders. Methods We retrospectively reviewed the data of 73 consecutive patients who received CRT. Patients were considered as super-responders after 6-month follow-up when NYHA class reduction to I or II combined with left ventricular ejection fraction (LVEF) ≥ 50% was observed. Patients were divided into super-responders group and non-super-responders group. All-cause mortality or hospitalization for heart failure (HF) was referred to the combined end point. Results 17 (23.3%) patients were super-responders. HF duration, left atrial dimension (LAD), and left bundle branch block (LBBB) were independent predictors of super-response to CRT. The combination of HF duration and LAD could provide more robust prediction of super-response than standalone HF duration (0.899 versus 0.789, Z = 2.207, P = 0.027) or standalone LAD (0.899 versus 0.775, Z = 2.487, P = 0.013). super-responders had excellent LV reverse remodeling. The cumulative incidences of combined end point were significantly lower in the super-responders group, LAD ≤ 42mm group, and combination of HF duration ≤ 48 months and LAD ≤ 42mm group. LBBB remained associated with a lowered risk of the combined end point (HR: 0.19, 95% CI: 0.07-0.57, P = 0.003), whereas LAD was associated with a raised risk of the combined end point (HR: 1.09, 95% CI: 1.02-1.17, P = 0.014). Conclusions HF duration, LAD, and LBBB independently predicted super-response. The combination of HF duration and LAD makes more robust prediction of CRT super-response. Super-responders had excellent LV reverse remodeling and decreased the incidences of the combined end point. LBBB and LAD were independently associated with the combined end point.
ISSN	23146133
Journal	Biomed Research International
Volume Number	2019
PubMed Central reference number	PMC6613035
PubMed reference number	31341894
e-ISSN	23146141
DOI	10.1155/2019/2983752
Language	English
Publisher	Hindawi
Publisher Date	2019-06-24
Access Restriction	Open
Rights License	This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © 2019 Zhinian Guo et al.
Content Type	Text
Resource Type	Article
Subject	Immunology and Microbiology Medicine Biochemistry, Genetics and Molecular Biology