Predictors of response to cardiac resynchronization therapy in chronic heart failure patients

Loutfi, Mohamed; Nawar, M. S.; Eltahan, Salah; Elhoda, Aly Abo

doi:10.1016/j.ehj.2016.01.001

Cited by 10 publications

(9 citation statements)

References 40 publications

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“…Studies have yielded con icting results regarding the predictors for the response to CRT. For example, the PROSPECT Trial did not uncover any independent parameters related to the responsiveness to CRT [11] , but a number of variables were identi ed in another study [21] . In contrast, few studies were performed to examine the variables predictive of response to LBBAP, although LBBAP is a viable alternative treatment to the traditional CRT.…”

Section: Discussionmentioning

confidence: 99%

Preoperative QRS Duration Predicts the Responsiveness of Chronic Heart Failure Patients with Pacemaker Indications To Left Bundle Branch Area Pacing Treatment

Chen

Fang

et al. 2021

Preprint

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Background This study investigated the predictive value of preoperative QRS duration (ORSd) in responsiveness of chronic heart failure (CHF) patients with pacemaker indications to the left bundle branch area pacing (LBBAP). Methods Thirty-one CHF patients with cardiac function categorized as NYHA class II or above and indications for pacemaker therapy who successfully underwent LBBAP treatment were enrolled in this study. Based on the 12-month postoperative responsiveness to treatment, patients were divided into a responsiveness group (n=18) and a no-responsiveness group (n=13). Data from all patients were collected for analysis. Multivariate binary logistic regression analysis was used to determine the independent factors associated with the responsiveness to LBBAP treatment. Results Among the 31 patients with LBBAP, 16 patients (51.6%) responded to the treatment, and 15 patients (48.4%) had no response. There were significant differences between these two groups with regard to complete left bundle branch block (CLBBB), preoperative QRSd, and preoperative left ventricular peak time (LVAT). Univariate logistic regression analysis showed that CLBBB, preoperative QRSd, and preoperative LVAT were all significantly correlated with responsiveness to LBBAP. Multivariate binary logistic regression analysis showed that ORSd was an independent predictor of responsiveness to LBBAP. The maximum area under the ROC curve for QRSd was 0.827, the maximum Youden index was 0.679, with the optimal cutoff point of QRSd ≥ 153 ms, a sensitivity of 81.3%, and a specificity of 86.7%. Conclusion Preoperative ORSd predicts the responsiveness of CHF patients with pacemaker indications to LBBAP.

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Section: Discussionmentioning

confidence: 99%

Preoperative QRS Duration Predicts the Responsiveness of Chronic Heart Failure Patients with Pacemaker Indications To Left Bundle Branch Area Pacing Treatment

Chen

Fang

et al. 2021

Preprint

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“…Обращает на себя внимание, что основные клинические показатели (пол, генез ХСН и ФК по NYHA) представлены в большинстве моделей, из лабораторных показателей чаще всего упоминается необходимость оценки уровней гемоглобина и креатинина как маркеров неблагоприятного прогноза [9,11]. Среди ЭхоКГ критериев на первый план выходит оценка ФВ ЛЖ и показателей механической диссинхронии [7,14,17 [4].…”

Section: Introductionunclassified

“…В связи с чем исследователями неоднократно предпринимались попытки по созданию комплексных моделей для предсказания ответа на СРТ и прогнозирования отдаленной выживаемости [4][5][6][7][8][9]. Ряд прогностических моделей был предложен на основании крупных многоцентровых исследований, включивших >3 тыс.…”

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“…пациентов [6,7]. Однако большинство моделей были созданы на основании одноцентровых исследований, к тому же некоторые из них учитывали лишь клинический или функциональный ответ на СРТ [8,9]. С учетом высокой стоимости СРТ и ее потенциальных осложнений, возможность оценки прогноза на дооперационном этапе является очень важной, в связи с чем дальнейшие исследования, касающиеся разработки комплексных моделей для прогнозирования эффекта СРТ и отдаленной выживаемости, являются актуальной задачей.…”

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Prediction of 5-year survival in patients with heart failure and implanted cardiac resynchronization therapy devices

et al. 2021

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Aim. Based on clinical parameters and diagnostic investigations, to create a complex model of personalized selection of patients with heart failure (HF) for cardiac resynchronization therapy (CRT). To establish the diagnostic value of the created model in predicting 5-year survival.Material and methods. The study included 141 patients with HF (men, 77,3%; women, 22,7%). The mean age of patients at the time of implantation was 60,0 [53,0; 66,0] years. All patients had New York Heart Association (NYHA) class II-IV HF, left ventricular ejection fraction (LVEF) ≤35%, and QRS ≥130 ms. Patients were randomly divided into training (n=95) and test (n=36) samples, which were comparable in main clinical and functional characteristics.Results. The index included parameters that had a significant relationship with 5-year survival according to the Cox regression: male sex, prior myocardial infarction, hypertension, QRS <150 ms, no left bundle branch block, PR ≥200 ms with sinus rhythm/absence of radiofrequency ablation in atrial fibrillation, NYHA class III, IV HF, LVEF <30%, left ventricular end-diastolic volume ≥235,0 ml, NT-proBNP ≥2692,0 ng/ml. All variables were scored based on the в-coefficients. In the training sample, a value ≥45 points demonstrated a sensitivity of 82,4% and a specificity of 67,2% in predicting 5-year survival (AUC, 0,873; p<0,001). The index use on the test sample showed comparable results (AUC, 0,718; p=0,020; sensitivity — 71,4%, specificity — 62,5%). Also, in the training sample, the index ≥45 points was associated with1-year survival (sensitivity — 84,6%, specificity — 58,1%, AUC, 0,811; p<0,001).Conclusion. An index of personalized selection for CRT has been created, which makes it possible to accurately predict the 5-year survival rate, as well as the 1-year survival rate, regardless of the current selection criteria.

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“…Various researches have addressed the results by predictors [16,8,10,17]. The research [18] investigated the relationship between the variables aimed at improving prediction of CRT response, and the research [19] investigated the analysis of data after optimizing the device and setting the device in different locations. In the researches [20,9,21,22], the effect of other cardiac factors in patients under CRT was investigated.…”

Section: -Introductionmentioning

confidence: 99%

Evaluation of Pattern Recognition Techniques in Response to Cardiac Resynchronization Therapy (CRT)

Nejadeh¹,

Bayat²,

Kheirkhah³

et al. 2020

JIST

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Cardiac resynchronization therapy (CRT) improves cardiac function in patients with heart failure (HF), and the result of this treatment is decrease in death rate and improving quality of life for patients. This research is aimed at predicting CRT response for the prognosis of patients with heart failure under CRT. According to international instructions, in the case of approval of QRS prolongation and decrease in ejection fraction (EF), the patient is recognized as a candidate of implanting recognition device. However, regarding many intervening and effective factors, decision making can be done based on more variables. Computer-based decision-making systems especially machine learning (ML) are considered as a promising method regarding their significant background in medical prediction. Collective intelligence approaches such as particles swarm optimization (PSO) algorithm are used for determining the priorities of medical decision-making variables. This investigation was done on 209 patients and the data was collected over 12 months. In HESHMAT CRT center, 17.7% of patients did not respond to treatment. Recognizing the dominant parameters through combining machine recognition and physician's viewpoint, and introducing back-propagation of error neural network algorithm in order to decrease classification error are the most important achievements of this research. In this research, an analytical set of individual, clinical, and laboratory variables, echocardiography, and electrocardiography (ECG) are proposed with patients' response to CRT. Prediction of the response after CRT becomes possible by the support of a set of tools, algorithms, and variables.

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Predictors of response to cardiac resynchronization therapy in chronic heart failure patients

Cited by 10 publications

References 40 publications

Preoperative QRS Duration Predicts the Responsiveness of Chronic Heart Failure Patients with Pacemaker Indications To Left Bundle Branch Area Pacing Treatment

Preoperative QRS Duration Predicts the Responsiveness of Chronic Heart Failure Patients with Pacemaker Indications To Left Bundle Branch Area Pacing Treatment

Prediction of 5-year survival in patients with heart failure and implanted cardiac resynchronization therapy devices

Evaluation of Pattern Recognition Techniques in Response to Cardiac Resynchronization Therapy (CRT)

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