Predictive value of clinical and echocardiographic parameters on cardiac resynchronization therapy

Abstract

Objective　To assess the value of echocardiographic parameters， N-terminal pro-brain natriuretic peptide (NT-proBNP)， and the duration of QRS wave (QRSd) in predicting the response to cardiac resynchronization therapy (CRT).Methods　Eighty patients accepted CRT because of refractory heart failure were enrolled. Echocardiography was performed to acquire two-dimensional echocardiography parameters and to evaluate inter-and intra-ventricular dyssynchrony before and after 6 months of CRT. The concentration of NT-proBNP was detected and QRSd was measured before and after 7 days of CRT implantation. At least 15% reduction in LVESV at the 6-month after CRT was defined as responders. Results　The standard deviation of time to peak myocardial systolic velocity of all 12 LV segments(Ts-12SD) is relatively valuable in predicting CRT responders (AUC＝0.703， P ＝0.019； Ts-12SD≥34.6 ms has the relatively high sensitivity of 61.8% and specificity of 70.6%)， other synchrony parameters could not predict the response to CRT(NS). The level of NT-proBNP before CRT implantation could predict the response to CRT (AUC＝0.75，P＝0.005). The QRSd could not predict the response to CRT(NS).Conclusions　Only Ts-12SD of echocardiographic parameters which were usually used could predict the response to CRT. The level of NT-proBNP before CRT implantation is valuable in predicting the response to CRT. The QRSd could not predict the response to CRT.