Predictors and Clinical Outcomes of Transient Responders to Cardiac Resynchronization Therapy
Background Left ventricular end‐systolic volume (LVESV) changes at 6 months and clinical status are useful for assessing responses to cardiac resynchronization therapy (CRT). Regression of the LVESV following CRT has not been described beyond 6 months. This study aimed to assess the proportion, pred...
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| Veröffentlicht in: | Pacing and clinical electrophysiology 2017-03, Vol.40 (3), p.301-309 |
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| creator | ICHIBORI, HIROTOSHI FUKUZAWA, KOJI KIUCHI, KUNIHIKO MATSUMOTO, AKINORI KONISHI, HIROKI IMADA, HIROSHI HYOGO, KIYOHIRO KUROSE, JUN TATSUMI, KAZUHIRO TANAKA, HIDEKAZU HIRATA, KEN‐ICHI |
| description | Background
Left ventricular end‐systolic volume (LVESV) changes at 6 months and clinical status are useful for assessing responses to cardiac resynchronization therapy (CRT). Regression of the LVESV following CRT has not been described beyond 6 months. This study aimed to assess the proportion, predictors, and clinical outcomes of responders whose LVESVs had regressed.
Methods
We retrospectively analyzed 104 consecutive CRT patients. A responder was defined as a patient with a relative reduction in the LVESV ≥15% at 6 months after CRT. Fifty‐six responders participated in this study. A transient responder was defined as a responder without a relative reduction in the LVESV ≥15% at 2 years after CRT or who died of cardiac events during the 24‐month follow‐up period.
Results
Of the 56 responders, 16 (29%) were transient responders. Multivariable logistic regression analysis showed that chronic atrial fibrillation (odds ratio [OR] = 19.2, 95% confidence interval [CI] [1.93, 190], P = 0.012) and amiodarone usage (OR = 60.9, 95% CI [4.18, 886], P = 0.003) were independent predictors of transient responses. Hospitalizations for heart failure were significantly higher among the transient responders than among the lasting responders during a mean follow‐up period of 7.6 years (log‐rank P < 0.001), and all‐cause mortality tended to be higher among the transient responders (log‐rank P = 0.093).
Conclusions
One‐third of the responders were transient responders at 2 years after CRT, and their long‐term prognoses were poor. Careful attention should be paid to maintain the reduction in LVESV especially in patients with chronic AF. |
| doi_str_mv | 10.1111/pace.13023 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1881760294</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1881760294</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4563-4ec046ff40920f5eaad54dbe3b16721e47467ec47405ded62a3e8928359adf4e3</originalsourceid><addsrcrecordid>eNqN0U9LHDEYBvAgSnervfgBZMCLFGZNJn8mc5RB28KCi6zHErLJOxiZTcZkhrL99M26tocexFxeCD8e3pcHoXOCFyS_60EbWBCKK3qE5oQzXErCm2M0x4TVpaSymaHPKT1jjAVm_BOaVRJL2ohmjn6uIlhnxhBTob0t2t55Z3Rf3E-jCVtIReiKddQ-OfBj8QBpCN5C1mMoWh2t02b_u_PmKQbvfuvRBV-snyDqYXeGTjrdJ_jyNk_R493tuv1eLu-__WhvlqVhXNCSgcFMdB3DTYU7DlpbzuwG6IaIuiLAaiZqMHlgbsGKSlOQTSUpb7TtGNBTdHXIHWJ4mSCNauuSgb7XHsKUFJGS1AJXDfsAFYQJLiqa6eV_9DlM0edDFMmLcs5qSrL6elAmhpQidGqIbqvjThGs9v2ofT_qtZ-ML94ip80W7D_6t5AMyAH8cj3s3olSq5v29hD6ByS_mhg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1920554731</pqid></control><display><type>article</type><title>Predictors and Clinical Outcomes of Transient Responders to Cardiac Resynchronization Therapy</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>ICHIBORI, HIROTOSHI ; FUKUZAWA, KOJI ; KIUCHI, KUNIHIKO ; MATSUMOTO, AKINORI ; KONISHI, HIROKI ; IMADA, HIROSHI ; HYOGO, KIYOHIRO ; KUROSE, JUN ; TATSUMI, KAZUHIRO ; TANAKA, HIDEKAZU ; HIRATA, KEN‐ICHI</creator><creatorcontrib>ICHIBORI, HIROTOSHI ; FUKUZAWA, KOJI ; KIUCHI, KUNIHIKO ; MATSUMOTO, AKINORI ; KONISHI, HIROKI ; IMADA, HIROSHI ; HYOGO, KIYOHIRO ; KUROSE, JUN ; TATSUMI, KAZUHIRO ; TANAKA, HIDEKAZU ; HIRATA, KEN‐ICHI</creatorcontrib><description>Background
Left ventricular end‐systolic volume (LVESV) changes at 6 months and clinical status are useful for assessing responses to cardiac resynchronization therapy (CRT). Regression of the LVESV following CRT has not been described beyond 6 months. This study aimed to assess the proportion, predictors, and clinical outcomes of responders whose LVESVs had regressed.
Methods
We retrospectively analyzed 104 consecutive CRT patients. A responder was defined as a patient with a relative reduction in the LVESV ≥15% at 6 months after CRT. Fifty‐six responders participated in this study. A transient responder was defined as a responder without a relative reduction in the LVESV ≥15% at 2 years after CRT or who died of cardiac events during the 24‐month follow‐up period.
Results
Of the 56 responders, 16 (29%) were transient responders. Multivariable logistic regression analysis showed that chronic atrial fibrillation (odds ratio [OR] = 19.2, 95% confidence interval [CI] [1.93, 190], P = 0.012) and amiodarone usage (OR = 60.9, 95% CI [4.18, 886], P = 0.003) were independent predictors of transient responses. Hospitalizations for heart failure were significantly higher among the transient responders than among the lasting responders during a mean follow‐up period of 7.6 years (log‐rank P < 0.001), and all‐cause mortality tended to be higher among the transient responders (log‐rank P = 0.093).
Conclusions
One‐third of the responders were transient responders at 2 years after CRT, and their long‐term prognoses were poor. Careful attention should be paid to maintain the reduction in LVESV especially in patients with chronic AF.</description><identifier>ISSN: 0147-8389</identifier><identifier>EISSN: 1540-8159</identifier><identifier>DOI: 10.1111/pace.13023</identifier><identifier>PMID: 28083969</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Aged ; all‐cause mortality ; Amiodarone ; cardiac resynchronization therapy ; Cardiac Resynchronization Therapy - mortality ; Cardiac Resynchronization Therapy - utilization ; Causality ; chronic atrial fibrillation ; Chronic Disease ; Clinical outcomes ; Comorbidity ; Disease-Free Survival ; Female ; Fibrillation ; Health risk assessment ; Heart diseases ; Heart Failure - diagnosis ; Heart Failure - mortality ; Heart Failure - prevention & control ; hospitalizations for heart failure ; Humans ; Japan - epidemiology ; Longitudinal Studies ; Male ; Prevalence ; Prognosis ; Reproducibility of Results ; responder ; Retrospective Studies ; Risk Factors ; Sensitivity and Specificity ; Stroke Volume ; Survival Rate ; Treatment Outcome ; Ventricle ; Ventricular Dysfunction, Left - diagnosis ; Ventricular Dysfunction, Left - mortality ; Ventricular Dysfunction, Left - prevention & control</subject><ispartof>Pacing and clinical electrophysiology, 2017-03, Vol.40 (3), p.301-309</ispartof><rights>2017 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4563-4ec046ff40920f5eaad54dbe3b16721e47467ec47405ded62a3e8928359adf4e3</citedby><cites>FETCH-LOGICAL-c4563-4ec046ff40920f5eaad54dbe3b16721e47467ec47405ded62a3e8928359adf4e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fpace.13023$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fpace.13023$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28083969$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ICHIBORI, HIROTOSHI</creatorcontrib><creatorcontrib>FUKUZAWA, KOJI</creatorcontrib><creatorcontrib>KIUCHI, KUNIHIKO</creatorcontrib><creatorcontrib>MATSUMOTO, AKINORI</creatorcontrib><creatorcontrib>KONISHI, HIROKI</creatorcontrib><creatorcontrib>IMADA, HIROSHI</creatorcontrib><creatorcontrib>HYOGO, KIYOHIRO</creatorcontrib><creatorcontrib>KUROSE, JUN</creatorcontrib><creatorcontrib>TATSUMI, KAZUHIRO</creatorcontrib><creatorcontrib>TANAKA, HIDEKAZU</creatorcontrib><creatorcontrib>HIRATA, KEN‐ICHI</creatorcontrib><title>Predictors and Clinical Outcomes of Transient Responders to Cardiac Resynchronization Therapy</title><title>Pacing and clinical electrophysiology</title><addtitle>Pacing Clin Electrophysiol</addtitle><description>Background
Left ventricular end‐systolic volume (LVESV) changes at 6 months and clinical status are useful for assessing responses to cardiac resynchronization therapy (CRT). Regression of the LVESV following CRT has not been described beyond 6 months. This study aimed to assess the proportion, predictors, and clinical outcomes of responders whose LVESVs had regressed.
Methods
We retrospectively analyzed 104 consecutive CRT patients. A responder was defined as a patient with a relative reduction in the LVESV ≥15% at 6 months after CRT. Fifty‐six responders participated in this study. A transient responder was defined as a responder without a relative reduction in the LVESV ≥15% at 2 years after CRT or who died of cardiac events during the 24‐month follow‐up period.
Results
Of the 56 responders, 16 (29%) were transient responders. Multivariable logistic regression analysis showed that chronic atrial fibrillation (odds ratio [OR] = 19.2, 95% confidence interval [CI] [1.93, 190], P = 0.012) and amiodarone usage (OR = 60.9, 95% CI [4.18, 886], P = 0.003) were independent predictors of transient responses. Hospitalizations for heart failure were significantly higher among the transient responders than among the lasting responders during a mean follow‐up period of 7.6 years (log‐rank P < 0.001), and all‐cause mortality tended to be higher among the transient responders (log‐rank P = 0.093).
Conclusions
One‐third of the responders were transient responders at 2 years after CRT, and their long‐term prognoses were poor. Careful attention should be paid to maintain the reduction in LVESV especially in patients with chronic AF.</description><subject>Aged</subject><subject>all‐cause mortality</subject><subject>Amiodarone</subject><subject>cardiac resynchronization therapy</subject><subject>Cardiac Resynchronization Therapy - mortality</subject><subject>Cardiac Resynchronization Therapy - utilization</subject><subject>Causality</subject><subject>chronic atrial fibrillation</subject><subject>Chronic Disease</subject><subject>Clinical outcomes</subject><subject>Comorbidity</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Fibrillation</subject><subject>Health risk assessment</subject><subject>Heart diseases</subject><subject>Heart Failure - diagnosis</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - prevention & control</subject><subject>hospitalizations for heart failure</subject><subject>Humans</subject><subject>Japan - epidemiology</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Prevalence</subject><subject>Prognosis</subject><subject>Reproducibility of Results</subject><subject>responder</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Sensitivity and Specificity</subject><subject>Stroke Volume</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><subject>Ventricle</subject><subject>Ventricular Dysfunction, Left - diagnosis</subject><subject>Ventricular Dysfunction, Left - mortality</subject><subject>Ventricular Dysfunction, Left - prevention & control</subject><issn>0147-8389</issn><issn>1540-8159</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqN0U9LHDEYBvAgSnervfgBZMCLFGZNJn8mc5RB28KCi6zHErLJOxiZTcZkhrL99M26tocexFxeCD8e3pcHoXOCFyS_60EbWBCKK3qE5oQzXErCm2M0x4TVpaSymaHPKT1jjAVm_BOaVRJL2ohmjn6uIlhnxhBTob0t2t55Z3Rf3E-jCVtIReiKddQ-OfBj8QBpCN5C1mMoWh2t02b_u_PmKQbvfuvRBV-snyDqYXeGTjrdJ_jyNk_R493tuv1eLu-__WhvlqVhXNCSgcFMdB3DTYU7DlpbzuwG6IaIuiLAaiZqMHlgbsGKSlOQTSUpb7TtGNBTdHXIHWJ4mSCNauuSgb7XHsKUFJGS1AJXDfsAFYQJLiqa6eV_9DlM0edDFMmLcs5qSrL6elAmhpQidGqIbqvjThGs9v2ofT_qtZ-ML94ip80W7D_6t5AMyAH8cj3s3olSq5v29hD6ByS_mhg</recordid><startdate>201703</startdate><enddate>201703</enddate><creator>ICHIBORI, HIROTOSHI</creator><creator>FUKUZAWA, KOJI</creator><creator>KIUCHI, KUNIHIKO</creator><creator>MATSUMOTO, AKINORI</creator><creator>KONISHI, HIROKI</creator><creator>IMADA, HIROSHI</creator><creator>HYOGO, KIYOHIRO</creator><creator>KUROSE, JUN</creator><creator>TATSUMI, KAZUHIRO</creator><creator>TANAKA, HIDEKAZU</creator><creator>HIRATA, KEN‐ICHI</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>201703</creationdate><title>Predictors and Clinical Outcomes of Transient Responders to Cardiac Resynchronization Therapy</title><author>ICHIBORI, HIROTOSHI ; FUKUZAWA, KOJI ; KIUCHI, KUNIHIKO ; MATSUMOTO, AKINORI ; KONISHI, HIROKI ; IMADA, HIROSHI ; HYOGO, KIYOHIRO ; KUROSE, JUN ; TATSUMI, KAZUHIRO ; TANAKA, HIDEKAZU ; HIRATA, KEN‐ICHI</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4563-4ec046ff40920f5eaad54dbe3b16721e47467ec47405ded62a3e8928359adf4e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>all‐cause mortality</topic><topic>Amiodarone</topic><topic>cardiac resynchronization therapy</topic><topic>Cardiac Resynchronization Therapy - mortality</topic><topic>Cardiac Resynchronization Therapy - utilization</topic><topic>Causality</topic><topic>chronic atrial fibrillation</topic><topic>Chronic Disease</topic><topic>Clinical outcomes</topic><topic>Comorbidity</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Fibrillation</topic><topic>Health risk assessment</topic><topic>Heart diseases</topic><topic>Heart Failure - diagnosis</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - prevention & control</topic><topic>hospitalizations for heart failure</topic><topic>Humans</topic><topic>Japan - epidemiology</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Prevalence</topic><topic>Prognosis</topic><topic>Reproducibility of Results</topic><topic>responder</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Sensitivity and Specificity</topic><topic>Stroke Volume</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><topic>Ventricle</topic><topic>Ventricular Dysfunction, Left - diagnosis</topic><topic>Ventricular Dysfunction, Left - mortality</topic><topic>Ventricular Dysfunction, Left - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>ICHIBORI, HIROTOSHI</creatorcontrib><creatorcontrib>FUKUZAWA, KOJI</creatorcontrib><creatorcontrib>KIUCHI, KUNIHIKO</creatorcontrib><creatorcontrib>MATSUMOTO, AKINORI</creatorcontrib><creatorcontrib>KONISHI, HIROKI</creatorcontrib><creatorcontrib>IMADA, HIROSHI</creatorcontrib><creatorcontrib>HYOGO, KIYOHIRO</creatorcontrib><creatorcontrib>KUROSE, JUN</creatorcontrib><creatorcontrib>TATSUMI, KAZUHIRO</creatorcontrib><creatorcontrib>TANAKA, HIDEKAZU</creatorcontrib><creatorcontrib>HIRATA, KEN‐ICHI</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pacing and clinical electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>ICHIBORI, HIROTOSHI</au><au>FUKUZAWA, KOJI</au><au>KIUCHI, KUNIHIKO</au><au>MATSUMOTO, AKINORI</au><au>KONISHI, HIROKI</au><au>IMADA, HIROSHI</au><au>HYOGO, KIYOHIRO</au><au>KUROSE, JUN</au><au>TATSUMI, KAZUHIRO</au><au>TANAKA, HIDEKAZU</au><au>HIRATA, KEN‐ICHI</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors and Clinical Outcomes of Transient Responders to Cardiac Resynchronization Therapy</atitle><jtitle>Pacing and clinical electrophysiology</jtitle><addtitle>Pacing Clin Electrophysiol</addtitle><date>2017-03</date><risdate>2017</risdate><volume>40</volume><issue>3</issue><spage>301</spage><epage>309</epage><pages>301-309</pages><issn>0147-8389</issn><eissn>1540-8159</eissn><abstract>Background
Left ventricular end‐systolic volume (LVESV) changes at 6 months and clinical status are useful for assessing responses to cardiac resynchronization therapy (CRT). Regression of the LVESV following CRT has not been described beyond 6 months. This study aimed to assess the proportion, predictors, and clinical outcomes of responders whose LVESVs had regressed.
Methods
We retrospectively analyzed 104 consecutive CRT patients. A responder was defined as a patient with a relative reduction in the LVESV ≥15% at 6 months after CRT. Fifty‐six responders participated in this study. A transient responder was defined as a responder without a relative reduction in the LVESV ≥15% at 2 years after CRT or who died of cardiac events during the 24‐month follow‐up period.
Results
Of the 56 responders, 16 (29%) were transient responders. Multivariable logistic regression analysis showed that chronic atrial fibrillation (odds ratio [OR] = 19.2, 95% confidence interval [CI] [1.93, 190], P = 0.012) and amiodarone usage (OR = 60.9, 95% CI [4.18, 886], P = 0.003) were independent predictors of transient responses. Hospitalizations for heart failure were significantly higher among the transient responders than among the lasting responders during a mean follow‐up period of 7.6 years (log‐rank P < 0.001), and all‐cause mortality tended to be higher among the transient responders (log‐rank P = 0.093).
Conclusions
One‐third of the responders were transient responders at 2 years after CRT, and their long‐term prognoses were poor. Careful attention should be paid to maintain the reduction in LVESV especially in patients with chronic AF.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28083969</pmid><doi>10.1111/pace.13023</doi><tpages>9</tpages></addata></record> |
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| subjects | Aged all‐cause mortality Amiodarone cardiac resynchronization therapy Cardiac Resynchronization Therapy - mortality Cardiac Resynchronization Therapy - utilization Causality chronic atrial fibrillation Chronic Disease Clinical outcomes Comorbidity Disease-Free Survival Female Fibrillation Health risk assessment Heart diseases Heart Failure - diagnosis Heart Failure - mortality Heart Failure - prevention & control hospitalizations for heart failure Humans Japan - epidemiology Longitudinal Studies Male Prevalence Prognosis Reproducibility of Results responder Retrospective Studies Risk Factors Sensitivity and Specificity Stroke Volume Survival Rate Treatment Outcome Ventricle Ventricular Dysfunction, Left - diagnosis Ventricular Dysfunction, Left - mortality Ventricular Dysfunction, Left - prevention & control |
| title | Predictors and Clinical Outcomes of Transient Responders to Cardiac Resynchronization Therapy |
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