A predictive model of super response to cardiac resynchronization therapy in short-term period.

IF 2.1 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Interventional Cardiac Electrophysiology Pub Date : 2024-11-01 Epub Date: 2024-06-19 DOI:10.1007/s10840-024-01844-5

Tariel A Atabekov, Anna I Mishkina, Mikhail S Khlynin, Svetlana I Sazonova, Sergey N Krivolapov, Roman E Batalov, Sergey V Popov

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引用次数: 0

Abstract

Background: The left bundle branch block, nonischemic heart failure (HF) and female gender are the most powerful predictors of a super response to cardiac resynchronization therapy (CRT). It is important to identify super responders who can derive most benefits from CRT. We aimed to establish a predicting model that could be used for prognosis of a super response to CRT in short-term period.

Methods: Patients with QRS ≥ 130 ms, New York Heart Association (NYHA) II-III class of HF, left ventricle ejection fraction (LVEF) ≤ 35% and indications for CRT were included in the study. Before and 6 month after CRT the electrocardiography, echocardiography and cardiac scintigraphy were performed. The study's primary endpoint was the NYHA class improvement ≥ 1 and left ventricle end systolic volume decrease > 30% or LVEF improvement > 15% after 6 month CRT. Based on collected data, we developed a predictive model regarding a super response to CRT.

Results: Of 49 (100.0%) patients, 32 (65.3%) had a super response to CRT. Patients with a super response were likelier to have a lower cardiac index (p = 0.007), higher rates of interventricular delay (IVD) (p = 0.003), phase standard deviation of left ventricle anterior wall (PSD LVAW) (p = 0.009) and ∆QRS (p = 0.02). Only IVD and PSD LVAW were independently associated with a super response to CRT in univariate and multivariate logistic regression. We created a logistic equation and calculated a cut-off value. The resulting ROC curve revealed a discriminative ability with AUC of 0.812 (sensitivity 90.62%; specificity 70.59%).

Conclusion: Our predictive model is able to distinguish patients with a super response to CRT.

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心脏再同步疗法短期超级反应的预测模型。

背景：左束支传导阻滞、非缺血性心力衰竭（HF）和女性性别是预测心脏再同步化治疗（CRT）超级反应的最有力因素。识别能从 CRT 中获得最大益处的超级响应者非常重要。我们的目的是建立一个预测模型，用于预测对 CRT 的短期超级反应：研究对象包括 QRS ≥ 130 ms、纽约心脏协会（NYHA）II-III 级 HF、左心室射血分数（LVEF）≤ 35% 且有 CRT 适应症的患者。在 CRT 治疗前和治疗后 6 个月，分别进行了心电图、超声心动图和心脏闪烁扫描。研究的主要终点是 CRT 6 个月后 NYHA 分级改善≥1，左心室收缩末期容积下降 > 30% 或 LVEF 改善 > 15%。根据收集到的数据，我们建立了一个关于 CRT 超级响应的预测模型：在 49 名（100.0%）患者中，32 名（65.3%）对 CRT 有超级反应。超级响应患者的心脏指数更低（p = 0.007），室间延迟（IVD）（p = 0.003）、左室前壁相位标准偏差（PSD LVAW）（p = 0.009）和ΔQRS（p = 0.02）的发生率更高。在单变量和多变量逻辑回归中，只有 IVD 和 PSD LVAW 与 CRT 的超级响应独立相关。我们建立了一个逻辑方程，并计算出一个临界值。得出的 ROC 曲线显示，该模型具有分辨能力，AUC 为 0.812（灵敏度 90.62%；特异度 70.59%）：结论：我们的预测模型能够区分对 CRT 有超级反应的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Interventional Cardiac Electrophysiology 医学-心血管系统

CiteScore

4.30

自引率

11.10%

发文量

320

审稿时长

4-8 weeks

期刊介绍： The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.