Introduction
Methods
Selection of patients
Device implantation
Visual assessment of LV-apical rocking
Endpoint
Statistical analysis
Results
Baseline characteristics
With apical rocking N = 134 | Without apical rocking N = 163 |
p-value | |
---|---|---|---|
Age (years) median (IQR)
| 67.3 (58.7–72.2) | 70.2 (63.5–75.2) | 0.001 |
Female
| 41 % | 22 % | < 0.001 |
LVEF (%) median (IQR)
| 25.0 (20.0–30.0) | 24.7 (20.0–30.0) | 0.929 |
Sinus rhythm
| 81 % | 71 % | 0.038 |
QRS duration (ms) median (IQR)
| 162 (147–180) | 150 (128–170) | < 0.001 |
LBBB
| 91 % | 73 % | < 0.001 |
RBBB
| 3 % | 9 % | 0.055 |
IVCD
| 6 % | 18 % | 0.003 |
NYHA functional class median (IQR)
| 3.0 (2.0–3.0) | 3.0 (2.0–3.0) | 0.637 |
Non-ischaemic aetiology
| 71 % | 31 % | < 0.001 |
Diuretics
| 77 % | 86 % | 0.044 |
Βeta-blocker
| 85 % | 80 % | 0.290 |
AT-II receptor blockers
| 48 % | 40 % | 0.137 |
ACE-inhibitors
| 77 % | 75 % | 0.782 |
Spironolactone
| 42 % | 45 % | 0.611 |
Non-super-responder N = 221 | Super-responder N = 76 |
p-value | |
---|---|---|---|
Age (years) median (IQR)
| 69.3 (61.5–74.3) | 67.6 (59.4–72.9) | 0.262 |
Female
| 25 % | 45 % | 0.002 |
LVEF (%) median (IQR)
| 25.0 (21.0–30.0) | 22.0 (18.0–25.5) | < 0.001 |
Sinus rhythm
| 75 % | 76 % | 0.821 |
QRS duration (ms) median (IQR)
| 160 (135–173) | 160 (132–182) | 0.238 |
LBBB
| 80 % | 86 % | 0.281 |
RBBB
| 7 % | 5 % | 0.770 |
IVCD
| 13 % | 9 % | 0.432 |
NYHA functional class median (IQR)
| 3.0 (2.0–3.0) | 3.0 (2.0–3.0) | 0.502 |
Non-ischaemic aetiology
| 40 % | 74 % | < 0.001 |
Diuretics
| 83 % | 79 % | 0.452 |
Βeta-blocker
| 81 % | 87 % | 0.216 |
AT-II receptor blockers
| 42 % | 47 % | 0.383 |
ACE-inhibitors
| 76 % | 74 % | 0.625 |
Spironolactone
| 46 % | 38 % | 0.253 |
Presence of apical rocking
| 34 % | 76 % | < 0.001 |
Non-super-responders (N = 221) | Super-responder (N = 76) |
p-value | ||
---|---|---|---|---|
Non-responders (N = 73) | Responders (N = 148) | |||
LVEF (%) at baseline median(IQR)
| 25.0 (21.0–29.0) | 25.0 (21.0–31.5) | 22.0 (18.0–25.5) | < 0.001 |
LVEF (%) during follow-up median(IQR)
| 24.0 (20.0–28.0) | 38.0 (30.0–43.0) | 49.0 (45.0–52.0) | < 0.001 |
LVESV decrease (ml) mean ± SD
| 4.3 ± 35.8 | 31.4 ± 37.6 | 6.5 ± 61.6 | < 0.001 |
Presence of apical rocking
| 15 % | 44 % | 76 % | < 0.001 |
Interobserver and intraobserver variability
Long-term outcome of super-responders
Apical rocking and super-response to CRT
Odds ratio | 95 % CI |
P-value | |
---|---|---|---|
Age (years)
| 1.01 | 0.97–1.05 | 0.585 |
Female
| 2.14 | 1.07–4.29 | 0.032 |
LVEF (%) baseline
| 0.89 | 0.84–0.94 | < 0.001 |
QRS duration (per 10 ms)
| 0.98 | 0.87–1.12 | 0.795 |
LBBB vs non-LBBB
| 0.91 | 0.33–2.49 | 0.858 |
Non-ischaemic aetiology
| 1.99 | 0.96–4.12 | 0.063 |
Presence of apical rocking
| 5.82 | 2.68–12.61 | < 0.001 |