TORNA ALL’ELENCO

Prognostic role of right ventricular function in patients with heart failure undergoing cardiac resynchronization therapy in Heart Rhythm

2015
ASL Torino 3

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (18)Vedi tutti...

Rapacciuolo A
Departments of Advanced Biomedical Sciences, Federico II University, Napoli, Italy, Ospedale SS Trinità, Borgomanero (NO), Italy, Ospedale G. Panico, Tricase (LE), Italy, Ospedale di Rivoli, Rivoli (TO), Italy, Policlinico Universitario, Padova, Italy, Ospedale Monaldi, Napoli, Italy, Casa di Cura Montevergine, Mercogliano (AV), Italy, A. O. Sant'Antonio Abate, Gallarate (VA), Italy, Ospedale Civile Ferrari, Castrovillari (CS), Italy, Boston Scientific, Milano, Italy, Ospedale Careggi, Firenze, Italy, Ospedale Sant'Anna, San Fermo della Battaglia (CO), Italy, Clinica Mediterranea, Napoli, Italy
Maffè S
Departments of Advanced Biomedical Sciences, Federico II University, Napoli, Italy, Ospedale SS Trinità, Borgomanero (NO), Italy, Ospedale G. Panico, Tricase (LE), Italy, Ospedale di Rivoli, Rivoli (TO), Italy, Policlinico Universitario, Padova, Italy, Ospedale Monaldi, Napoli, Italy, Casa di Cura Montevergine, Mercogliano (AV), Italy, A. O. Sant'Antonio Abate, Gallarate (VA), Italy, Ospedale Civile Ferrari, Castrovillari (CS), Italy, Boston Scientific, Milano, Italy, Ospedale Careggi, Firenze, Italy, Ospedale Sant'Anna, San Fermo della Battaglia (CO), Italy, Clinica Mediterranea, Napoli, Italy
Palmisano P
Departments of Advanced Biomedical Sciences, Federico II University, Napoli, Italy, Ospedale SS Trinità, Borgomanero (NO), Italy, Ospedale G. Panico, Tricase (LE), Italy, Ospedale di Rivoli, Rivoli (TO), Italy, Policlinico Universitario, Padova, Italy, Ospedale Monaldi, Napoli, Italy, Casa di Cura Montevergine, Mercogliano (AV), Italy, A. O. Sant'Antonio Abate, Gallarate (VA), Italy, Ospedale Civile Ferrari, Castrovillari (CS), Italy, Boston Scientific, Milano, Italy, Ospedale Careggi, Firenze, Italy, Ospedale Sant'Anna, San Fermo della Battaglia (CO), Italy, Clinica Mediterranea, Napoli, Italy

et alii...

Abstract

Introduction: Since 20-40% of patients undergoing CRT do not respond to therapy, the identification of potential factors predicting response to CRT is a relevant research topic. Recent evidence suggests a possible association between right ventricular function and response to CRT. Methods: We analyzed data from the CRT MORE registry, about patients who received CRT according to current guidelines (NYHA class II-IV, optimal medical drug therapy, Left ventricular ejection fraction (LVEF) ? 35% and a QRS duration ? 120ms) from April 2013 to December 2013. Response to therapy was defined as an absolute improvement in LVEF ? 10% and as a decrease of at least 15% in left ventricular end-systolic volume (LVESV) on echocardiography at 6 months. Results: A total of 163 patients with a baseline estimation of tricuspid annular plane systolic excursion (TAPSE) and echocardiographic examination at 6 months follow up were considered for this analysis (age 70±10 years, male gender 71%, ischemic etiology 37%, history of atrial fibrillation 27%, NYHA class II in 46% of patients, spontaneous QRS duration 160±25ms, left bundle branch block 85%). Baseline echocardiographic parameters were: LVEF 28±6%, Mitral regurgitation grade ? 3 in 31% of patients, TAPSE 18.8±5mm, LVESV132±48 ml. On the basis of receiver operating characteristic curve analysis of TAPSE, the cutoff that best predicted improvement in LVEF (sensitivity 60%, specificity 61%) and LVESV (sensitivity 69%, specificity 52%) was 17mm. Stratifying patients according to the TAPSE, LVEF improved ? 10% in 49% of patients with TAPSE ?17mm (versus 30% in patients with TAPSE >17mm, p=0.019) and LVESV decreased ? 15% in 79% of patients with TAPSE ?17mm (versus 59%, p=0.008). At multivariate analysis, TAPSE ?17mm was independently associated with LVESV improvement (OR 2.26, 95% CI 1.1 to 4.6, p= 0.024), together with ischemic etiology (OR 0.44, 95% CI 0.22 to 0.89, p= 0.022). TAPSE ? 17mm was the only p

Keywords

heart rhythm; human; heart failure; cardiac resynchronization therapy; patient; society; heart ventricle function; QRS interval; etiology; therapy; heart left ventricle ejection fraction; drug therapy; follow up; register; echocardiography; examination; multivariate analysis; gender; heart left ventricle endsystolic volume; atrial fibrillation; receiver operating characteristic; mitral valve regurgitation; parameters; heart left bundle branch block; male; New York Heart Association class;