Prognostic utility of the assessment of diastolic function in patients undergoing cardiac resynchronization therapy.
Int J Cardiol
; 331: 144-151, 2021 05 15.
Article
in En
| MEDLINE
| ID: mdl-33535079
ABSTRACT
Conflicting data exist about the relationship between cardiac resynchronization therapy (CRT) and diastolic function. Aims of the study are to assess diastolic patterns in patients undergoing CRT according to the 2016 recommendations of the American Society of Echocardiography/European Association of Cardiovascular Imaging and to evaluate the prognostic value of diastolic dysfunction (DD) in CRT candidates. METHODS AND RESULTS:
One-hundred ninety-three patients (age 67 ± 11 years, QRS width 167 ± 21 ms) were included in this multicentre prospective study. Mitral filling pattern, mitral tissue Doppler velocity, tricuspid regurgitation velocity, and indexed left atrial volume were used to classify DD from grade I to III. CRT-response, defined as a reduction of left ventricular (LV) end-systolic volume > 15% at 6-month follow-up (FU), occurred in 132 (68%) patients. The primary endpoint was a composite of heart transplantation, LV assisted device implantation, or all-cause death during FU and occurred in 29 (15%) patients. CRT was associated with a degradation of DD in non-responders. At multivariable analysis corrected for clinical variables, QRS duration, mitral regurgitation, CRT-response and LV dyssynchrony, grade I DD was associated with a better outcome (HR 0.37, 95% CI 0.14-0.96). Non-responders with grade II-III DD had the worse prognosis (HR 4.36, 95%CI 2.10-9.06).CONCLUSIONS:
The evaluation of DD in CRT candidates allows the prognostic stratification of patients, independently from CRT-response.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cardiac Resynchronization Therapy
/
Heart Failure
Type of study:
Clinical_trials
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Humans
/
Middle aged
Language:
En
Journal:
Int J Cardiol
Year:
2021
Document type:
Article
Affiliation country:
France