Baseline QRS width and mitral regurgitation behavior after cardiac resynchronization therapy among patients with dilated cardiomyopathy

Atta, Salah; Bashandy, Mohamed A.; Zaky, Sherif

doi:10.1016/j.ehj.2013.08.005

Cited by 2 publications

(1 citation statement)

References 30 publications

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“…On the other hand, studies have shown that the effect of CRT in improving the degree of MR is limited. [42] Severe LV dilatation, irreversible MR and extremely severe regurgitation may be the reasons why CRT was unresponsive in these studies. Hence, longer follow-up observations to obtain more accurate ultrasonic parameters are required to see whether NICM patients could also benefit more from CRT in terms of the MR severity and PASP in the long run.…”

Section: Discussionmentioning

confidence: 93%

Etiologic impact on difference on clinical outcomes of patients with heart failure after cardiac resynchronization therapy

et al. 2018

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Section: Discussionmentioning

confidence: 93%

Etiologic impact on difference on clinical outcomes of patients with heart failure after cardiac resynchronization therapy

et al. 2018

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Evolution and prognosis of tricuspid and mitral regurgitation following cardiac implantable electronic devices: a systematic review and meta-analysis

Yuyun,

Joseph,

Erqou

et al. 2024

Europace

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Background Significant changes in tricuspid regurgitation (TR) and mitral regurgitation (MR) post-cardiac implantable electronic devices (CIED) are increasingly recognized. However, uncertainty remains as to whether risk of CIED-associated TR and MR differs with right ventricular pacing (RVP) via CIED with trans-tricuspid RV leads, compared to cardiac resynchronization therapy (CRT), conduction system pacing (CSP), and leadless pacing (LP). Aims Synthesize extant data on risk and prognosis of significant post-CIED TR and MR across pacing strategies. Methods We searched PubMed, EMBASE, and Cochrane Library databases published until October 31st, 2023. Significant post-CIED TR and MR were defined as ≥ moderate. Results Fifty-seven TR studies (N=13,723 patients) and 90 MR studies (N =14,387 patients) were included. For all CIED, risk of post-CIED TR increased (pooled odds ratio (OR)=2.46 and 95% CI=1.88-3.22), while risk of post-CIED MR reduced (OR=0.74, 95% CI=0.58-0.94) after 12 and 6 months of median follow-up respectively. RVP via CIED with trans-tricuspid RV leads was associated with increased risk of post-CIED TR (OR=4.54, 95% CI=3.14-6.57) and post-CIED MR (OR=2.24, 95% CI=1.18-4.26). Binarily, CSP did not alter TR risk (OR=0.37, 95% CI=0.13-1.02), but significantly reduced MR (OR =0.15, 95% CI=0.03-0.62). CRT did not significantly change TR risk (OR=1.09, 95% CI=0.55-2.17), but significantly reduced MR with prevalence pre-CRT of 43%, decreasing post-CRT to 22% (OR =0.49, 95% CI=0.40-0.61). There was no significant association of LP with post-CIED TR (OR=1.15, 95% CI=0.83-1.59) or MR (OR=1.31, 95% CI=0.72-2.39). CIED-associated TR was independently predictive of all-cause mortality (pooled hazard ratio (HR)=1.64, 95% CI=1.40-1.90) after median of 53 months. MR persisting post-CRT independently predicted all-cause mortality (HR=2.00, 95% CI=1.57-2.55) after 38 months. Conclusions Our findings suggest that, when possible, adoption of pacing strategies which avoid isolated trans-tricuspid RV leads may be beneficial in preventing incident or deteriorating atrioventricular valvular regurgitation and might reduce mortality.

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Baseline QRS width and mitral regurgitation behavior after cardiac resynchronization therapy among patients with dilated cardiomyopathy

Cited by 2 publications

References 30 publications

Etiologic impact on difference on clinical outcomes of patients with heart failure after cardiac resynchronization therapy

Etiologic impact on difference on clinical outcomes of patients with heart failure after cardiac resynchronization therapy

Evolution and prognosis of tricuspid and mitral regurgitation following cardiac implantable electronic devices: a systematic review and meta-analysis

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