Predictors of echocardiographic response to cardiac resynchronization therapy: A systematic review with Meta-Analysis

Martins, Ricardo; António, Natália; Donato, Helena; Oliveiros, Bárbara

doi:10.1016/j.ijcha.2022.100979

Cited by 1 publication

(1 citation statement)

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“…The site of LV electrode implantation and the post-intervention management may determine the response to CRT in a predictable way, but the most challenging parameter remains patient selection [4]. Although the response to CRT is clinically judged, which requires a long-term clinical follow-up, there is a growing body of evidence investigating the echocardiographic-based response, a surrogate marker of clinical response [5]. Over and above other indices, a significant reduction (by ≥15%) in LV end-systolic volume (LVESV) has been proposed as an echocardiographic-derived index of effective response to CRT-D implantation [6].…”

Section: Introductionmentioning

confidence: 99%

The Prognostic Role of Global Longitudinal Strain and NT-proBNP in Heart Failure Patients Receiving Cardiac Resynchronization Therapy

Kadoglou,

Bouwmeester,

de Lepper

et al. 2024

JPM

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Background: We aimed to evaluate whether baseline GLS (global longitudinal strain), NT-proBNP, and changes in these after cardiac resynchronization therapy (CRT) can predict long-term clinical outcomes and the echocardiographic-based response to CRT (defined by 15% relative reduction in left ventricular end-systolic volume). Methods: We enrolled 143 patients with stable ischemic heart failure (HF) undergoing CRT-D implantation. NT-proBNP and echocardiography were obtained before and 6 months after. The patients were followed up (median: 58 months) for HF-related deaths and/or HF hospitalizations (primary endpoint) or HF-related deaths (secondary endpoint). Results: A total of 84 patients achieved the primary and 53 the secondary endpoint, while 104 patients were considered CRT responders and 39 non-responders. At baseline, event-free patients had higher absolute GLS values (p < 0.001) and lower NT-proBNP serum levels (p < 0001) than those achieving the primary endpoint. A similar pattern was observed in favor of CRT responders vs. non-responders. On Cox regression analysis, baseline absolute GLS value (HR = 0.77; 95% CI, 0.51–1.91; p = 0.002) was beneficially associated with lower primary endpoint incidence, while baseline NT-proBNP levels (HR = 1.55; 95% CI, 1.43–2.01; p = 0.002) and diabetes presence (HR = 1.27; 95% CI, 1.12–1.98; p = 0.003) were related to higher primary endpoint incidence. Conclusions: In HF patients undergoing CRT-D, baseline GLS and NT-proBNP concentrations may serve as prognostic factors, while they may predict the echocardiographic-based response to CRT.

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Section: Introductionmentioning

confidence: 99%