Analyses of super-response to cardiac resynchronization therapy in patients with congestive heart failure: a multiple center trial
10.3760/cma.j.issn.0253-3758.2013.08.008
- VernacularTitle:双心室再同步化治疗心力衰竭的超应答多中心研究
- Keywords:
Heart failure,congestive;
Pacemaker,artificial
- From:
Chinese Journal of Cardiology
2013;41(8):662-667
- CountryChina
- Language:Chinese
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Abstract:
Objective To evaluate the incidence of super-response and the potential predictors related to super-response after cardiac resynchronization therapy (CRT)in patients with congestive heart failure.Methods 190 patients [145 men and45 women;age:(60.48 ±11.91) years] underwent CRT between March 2001 and March 2012 were enrolled in this multi-center trial,of which,54 patients with ischemic cardiomyopathy and 136 patients with non-ischemic cardiomyopathy.These patients were followed up from 6 months to 11 years (mean 58 months) post CRT.Results Ten patients died within 6 months post CRT,the others were followed up for more than 6 months.At 6-month follow-up,51 patients were identified as CRT super-responders (28.33％),75 patients were CRT responders (41.67％) and 29 patients were CRT non-responders (16.11％),and 25 patients were CRT negative responders (13.89％).Super-response occurred more frequently in non-ischemic cardiomyopathy patients,while non-response most commonly occurred in ischemic cardiomyopathy patients (P ＜ 0.05) ; patients in the negative response group had higher serum creatinine level than other groups (P ＜ 0.05),and patients in the non-response group and negative response group had higher pulmonary artery pressure than patients in the super-response group(P ＜0.05) ;the average QRS duration was ≥160 ms before CRT,and the mean decrease was around 30 ms after CRT in the super-response group while the average QRS duration was 139 ms before CRT,and the mean reduction was around 8 ms after CRT in the negative response group (P ＜ 0.05).LV lead position in the super-response group was usually in the middle and base of the heart,while in the negative response group it was more commonly located in the apex of the heart (P ＜ 0.01).Conclusions LV lead located at the middle and pre-CRT ORS duration ≥ 160 ms are associated with super-response post CRT procedure in this patient cohort.
