Heart failureUsefulness of Left Ventricular Systolic Dyssynchrony by Real-Time Three-Dimensional Echocardiography to Predict Long-Term Response to Cardiac Resynchronization Therapy
Section snippets
Population
The study comprised 90 consecutive patients with HF (60 ± 12 years of age, 73% men) who received CRT-D and had (1) New York Heart Association functional class ≥III despite optimal drug therapy, (2) impaired LV ejection fraction (<35%), and (3) wide QRS complex >120 ms. Patients with atrial fibrillation, acute coronary syndrome, or coronary revascularization within 6 months before CRT were excluded. Informed consent was obtained from all patients and the institutional review board approved the
Baseline data
Out of the originally enrolled 100 patients, 6 patients (6%) were excluded due to poor RT3DE image quality and 4 patients had died during the first year after CRT. The final study cohort included 90 patients (mean age 60 ± 12 years, 73% men). Forty-six patients (51%) had ischemic HF and 44 patients (49%) had nonischemic HF. Eighty-seven patients (97%) were in New York Heart Association class III, and 3 patients were in New York Heart Association class IV. Baseline clinical characteristics of
Discussion
The main findings of this prospective study are that (1) RT3DE showed reverse volumetric LV remodeling in 76% of patients with HF treated by CRT-D after 12-month follow-up and (2) the SDI predicted reverse LV remodeling after CRT with a high positive likelihood ratio and a minimal negative likelihood ratio. In most CRT studies 2-dimensional echocardiography has been used for assessment of LV size and function before and after CRT. However, the accuracy of serial measurements of LV volume from
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