Optimal Left Ventricular Lead Position Predicts Reverse Remodeling and Survival After Cardiac Resynchronization Therapy
Objectives The aim of the current study was to evaluate echocardiographic parameters after 6 months of cardiac resynchronization therapy (CRT) as well as long-term outcome in patients with the left ventricular (LV) lead positioned at the site of latest activation (concordant LV lead position) as com...
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| creator | Ypenburg, Claudia, MD van Bommel, Rutger J., MD Delgado, Victoria, MD Mollema, Sjoerd A., MD Bleeker, Gabe B., MD, PhD Boersma, Eric, PhD Schalij, Martin J., MD, PhD Bax, Jeroen J., MD, PhD |
| description | Objectives The aim of the current study was to evaluate echocardiographic parameters after 6 months of cardiac resynchronization therapy (CRT) as well as long-term outcome in patients with the left ventricular (LV) lead positioned at the site of latest activation (concordant LV lead position) as compared with that seen in patients with a discordant LV lead position. Background A nonoptimal LV pacing lead position may be a potential cause for nonresponse to CRT. Methods The site of latest mechanical activation was determined by speckle tracking radial strain analysis and related to the LV lead position on chest X-ray in 244 CRT candidates. Echocardiographic evaluation was performed after 6 months. Long-term follow-up included all-cause mortality and hospitalizations for heart failure. Results Significant LV reverse remodeling (reduction in LV end-systolic volume from 189 ± 83 ml to 134 ± 71 ml, p < 0.001) was noted in the group of patients with a concordant LV lead position (n = 153, 63%), whereas patients with a discordant lead position showed no significant improvements. In addition, during long-term follow-up (32 ± 16 months), less events (combined for heart failure hospitalizations and death) were reported in patients with a concordant LV lead position. Moreover, a concordant LV lead position appeared to be an independent predictor of hospitalization-free survival after long-term CRT (hazard ratio: 0.22, p = 0.004). Conclusions Pacing at the site of latest mechanical activation, as determined by speckle tracking radial strain analysis, resulted in superior echocardiographic response after 6 months of CRT and better prognosis during long-term follow-up. |
| doi_str_mv | 10.1016/j.jacc.2008.06.046 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_69697914</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0735109708026314</els_id><sourcerecordid>69697914</sourcerecordid><originalsourceid>FETCH-LOGICAL-c583t-bb54f4d13c0d2ea674beb3a3457273b5a276c3759a023f6f048e2a9439911c863</originalsourceid><addsrcrecordid>eNp9klGL1DAUhYMo7uzqH_BBCoJvrTdJkzQgwjK4Kgzs4q6-hjS9dVM77Zi0I-OvN3UGFvbBpwvhO4fccy4hrygUFKh81xWdda5gAFUBsoBSPiErKkSVc6HVU7ICxUVOQaszch5jBwCyovo5OaOVLkFwuiK_r3eT39o-22A7Zd9xmIJ3c29DerBNdjNGP_lxyG4CNt5NMfuKewwR09yODfZ--JHZoclu57D3--Rz2U4YsrUNjbcuUfEwuPswDv6P_Wd0d4_B7g4vyLPW9hFfnuYF-Xb18W79Od9cf_qyvtzkTlR8yutalG3ZUO6gYWilKmusueWlUEzxWlimpONKaAuMt7KFskJmdcm1ptRVkl-Qt0ffXRh_zRgns_XRYd_bAcc5GqmlVpqWCXzzCOzGOQzpb4YKkIwrXS0UO1IujDEGbM0upPjCwVAwSymmM0spZinFgDSplCR6fbKe6y02D5JTCwl4fwQwJbH3GEx0HgeXIg_oJtOM_v_-Hx7JXerFO9v_xAPGhz1MZAbM7XIWy1VABUzytPtfrbayyw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1506237984</pqid></control><display><type>article</type><title>Optimal Left Ventricular Lead Position Predicts Reverse Remodeling and Survival After Cardiac Resynchronization Therapy</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Ypenburg, Claudia, MD ; van Bommel, Rutger J., MD ; Delgado, Victoria, MD ; Mollema, Sjoerd A., MD ; Bleeker, Gabe B., MD, PhD ; Boersma, Eric, PhD ; Schalij, Martin J., MD, PhD ; Bax, Jeroen J., MD, PhD</creator><creatorcontrib>Ypenburg, Claudia, MD ; van Bommel, Rutger J., MD ; Delgado, Victoria, MD ; Mollema, Sjoerd A., MD ; Bleeker, Gabe B., MD, PhD ; Boersma, Eric, PhD ; Schalij, Martin J., MD, PhD ; Bax, Jeroen J., MD, PhD</creatorcontrib><description>Objectives The aim of the current study was to evaluate echocardiographic parameters after 6 months of cardiac resynchronization therapy (CRT) as well as long-term outcome in patients with the left ventricular (LV) lead positioned at the site of latest activation (concordant LV lead position) as compared with that seen in patients with a discordant LV lead position. Background A nonoptimal LV pacing lead position may be a potential cause for nonresponse to CRT. Methods The site of latest mechanical activation was determined by speckle tracking radial strain analysis and related to the LV lead position on chest X-ray in 244 CRT candidates. Echocardiographic evaluation was performed after 6 months. Long-term follow-up included all-cause mortality and hospitalizations for heart failure. Results Significant LV reverse remodeling (reduction in LV end-systolic volume from 189 ± 83 ml to 134 ± 71 ml, p < 0.001) was noted in the group of patients with a concordant LV lead position (n = 153, 63%), whereas patients with a discordant lead position showed no significant improvements. In addition, during long-term follow-up (32 ± 16 months), less events (combined for heart failure hospitalizations and death) were reported in patients with a concordant LV lead position. Moreover, a concordant LV lead position appeared to be an independent predictor of hospitalization-free survival after long-term CRT (hazard ratio: 0.22, p = 0.004). Conclusions Pacing at the site of latest mechanical activation, as determined by speckle tracking radial strain analysis, resulted in superior echocardiographic response after 6 months of CRT and better prognosis during long-term follow-up.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/j.jacc.2008.06.046</identifier><identifier>PMID: 18940531</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Cardiac arrhythmia ; Cardiac Pacing, Artificial - methods ; Cardiology ; Cardiovascular ; Cardiovascular disease ; Drug therapy ; echocardiography ; Echocardiography, Doppler ; Electrodes, Implanted ; Female ; Forecasting ; Heart attacks ; Heart failure ; Heart Failure - diagnostic imaging ; Heart Failure - therapy ; Heart Ventricles - diagnostic imaging ; Heart Ventricles - physiopathology ; Hospitalization ; Humans ; Internal Medicine ; lead position ; Male ; Medical prognosis ; Middle Aged ; Ostomy ; Pacemaker, Artificial ; resynchronization therapy ; Severity of Illness Index ; Stroke Volume ; Studies ; Survival Analysis ; Time Factors ; Tomography ; Treatment Outcome ; Ventricular Remodeling</subject><ispartof>Journal of the American College of Cardiology, 2008-10, Vol.52 (17), p.1402-1409</ispartof><rights>American College of Cardiology Foundation</rights><rights>2008 American College of Cardiology Foundation</rights><rights>Copyright Elsevier Limited Oct 21, 2008</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c583t-bb54f4d13c0d2ea674beb3a3457273b5a276c3759a023f6f048e2a9439911c863</citedby><cites>FETCH-LOGICAL-c583t-bb54f4d13c0d2ea674beb3a3457273b5a276c3759a023f6f048e2a9439911c863</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0735109708026314$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18940531$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ypenburg, Claudia, MD</creatorcontrib><creatorcontrib>van Bommel, Rutger J., MD</creatorcontrib><creatorcontrib>Delgado, Victoria, MD</creatorcontrib><creatorcontrib>Mollema, Sjoerd A., MD</creatorcontrib><creatorcontrib>Bleeker, Gabe B., MD, PhD</creatorcontrib><creatorcontrib>Boersma, Eric, PhD</creatorcontrib><creatorcontrib>Schalij, Martin J., MD, PhD</creatorcontrib><creatorcontrib>Bax, Jeroen J., MD, PhD</creatorcontrib><title>Optimal Left Ventricular Lead Position Predicts Reverse Remodeling and Survival After Cardiac Resynchronization Therapy</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>Objectives The aim of the current study was to evaluate echocardiographic parameters after 6 months of cardiac resynchronization therapy (CRT) as well as long-term outcome in patients with the left ventricular (LV) lead positioned at the site of latest activation (concordant LV lead position) as compared with that seen in patients with a discordant LV lead position. Background A nonoptimal LV pacing lead position may be a potential cause for nonresponse to CRT. Methods The site of latest mechanical activation was determined by speckle tracking radial strain analysis and related to the LV lead position on chest X-ray in 244 CRT candidates. Echocardiographic evaluation was performed after 6 months. Long-term follow-up included all-cause mortality and hospitalizations for heart failure. Results Significant LV reverse remodeling (reduction in LV end-systolic volume from 189 ± 83 ml to 134 ± 71 ml, p < 0.001) was noted in the group of patients with a concordant LV lead position (n = 153, 63%), whereas patients with a discordant lead position showed no significant improvements. In addition, during long-term follow-up (32 ± 16 months), less events (combined for heart failure hospitalizations and death) were reported in patients with a concordant LV lead position. Moreover, a concordant LV lead position appeared to be an independent predictor of hospitalization-free survival after long-term CRT (hazard ratio: 0.22, p = 0.004). Conclusions Pacing at the site of latest mechanical activation, as determined by speckle tracking radial strain analysis, resulted in superior echocardiographic response after 6 months of CRT and better prognosis during long-term follow-up.</description><subject>Aged</subject><subject>Cardiac arrhythmia</subject><subject>Cardiac Pacing, Artificial - methods</subject><subject>Cardiology</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Drug therapy</subject><subject>echocardiography</subject><subject>Echocardiography, Doppler</subject><subject>Electrodes, Implanted</subject><subject>Female</subject><subject>Forecasting</subject><subject>Heart attacks</subject><subject>Heart failure</subject><subject>Heart Failure - diagnostic imaging</subject><subject>Heart Failure - therapy</subject><subject>Heart Ventricles - diagnostic imaging</subject><subject>Heart Ventricles - physiopathology</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>lead position</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Middle Aged</subject><subject>Ostomy</subject><subject>Pacemaker, Artificial</subject><subject>resynchronization therapy</subject><subject>Severity of Illness Index</subject><subject>Stroke Volume</subject><subject>Studies</subject><subject>Survival Analysis</subject><subject>Time Factors</subject><subject>Tomography</subject><subject>Treatment Outcome</subject><subject>Ventricular Remodeling</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9klGL1DAUhYMo7uzqH_BBCoJvrTdJkzQgwjK4Kgzs4q6-hjS9dVM77Zi0I-OvN3UGFvbBpwvhO4fccy4hrygUFKh81xWdda5gAFUBsoBSPiErKkSVc6HVU7ICxUVOQaszch5jBwCyovo5OaOVLkFwuiK_r3eT39o-22A7Zd9xmIJ3c29DerBNdjNGP_lxyG4CNt5NMfuKewwR09yODfZ--JHZoclu57D3--Rz2U4YsrUNjbcuUfEwuPswDv6P_Wd0d4_B7g4vyLPW9hFfnuYF-Xb18W79Od9cf_qyvtzkTlR8yutalG3ZUO6gYWilKmusueWlUEzxWlimpONKaAuMt7KFskJmdcm1ptRVkl-Qt0ffXRh_zRgns_XRYd_bAcc5GqmlVpqWCXzzCOzGOQzpb4YKkIwrXS0UO1IujDEGbM0upPjCwVAwSymmM0spZinFgDSplCR6fbKe6y02D5JTCwl4fwQwJbH3GEx0HgeXIg_oJtOM_v_-Hx7JXerFO9v_xAPGhz1MZAbM7XIWy1VABUzytPtfrbayyw</recordid><startdate>20081021</startdate><enddate>20081021</enddate><creator>Ypenburg, Claudia, MD</creator><creator>van Bommel, Rutger J., MD</creator><creator>Delgado, Victoria, MD</creator><creator>Mollema, Sjoerd A., MD</creator><creator>Bleeker, Gabe B., MD, PhD</creator><creator>Boersma, Eric, PhD</creator><creator>Schalij, Martin J., MD, PhD</creator><creator>Bax, Jeroen J., MD, PhD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><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>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20081021</creationdate><title>Optimal Left Ventricular Lead Position Predicts Reverse Remodeling and Survival After Cardiac Resynchronization Therapy</title><author>Ypenburg, Claudia, MD ; van Bommel, Rutger J., MD ; Delgado, Victoria, MD ; Mollema, Sjoerd A., MD ; Bleeker, Gabe B., MD, PhD ; Boersma, Eric, PhD ; Schalij, Martin J., MD, PhD ; Bax, Jeroen J., MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c583t-bb54f4d13c0d2ea674beb3a3457273b5a276c3759a023f6f048e2a9439911c863</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Aged</topic><topic>Cardiac arrhythmia</topic><topic>Cardiac Pacing, Artificial - methods</topic><topic>Cardiology</topic><topic>Cardiovascular</topic><topic>Cardiovascular disease</topic><topic>Drug therapy</topic><topic>echocardiography</topic><topic>Echocardiography, Doppler</topic><topic>Electrodes, Implanted</topic><topic>Female</topic><topic>Forecasting</topic><topic>Heart attacks</topic><topic>Heart failure</topic><topic>Heart Failure - diagnostic imaging</topic><topic>Heart Failure - therapy</topic><topic>Heart Ventricles - diagnostic imaging</topic><topic>Heart Ventricles - physiopathology</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>lead position</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Middle Aged</topic><topic>Ostomy</topic><topic>Pacemaker, Artificial</topic><topic>resynchronization therapy</topic><topic>Severity of Illness Index</topic><topic>Stroke Volume</topic><topic>Studies</topic><topic>Survival Analysis</topic><topic>Time Factors</topic><topic>Tomography</topic><topic>Treatment Outcome</topic><topic>Ventricular Remodeling</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ypenburg, Claudia, MD</creatorcontrib><creatorcontrib>van Bommel, Rutger J., MD</creatorcontrib><creatorcontrib>Delgado, Victoria, MD</creatorcontrib><creatorcontrib>Mollema, Sjoerd A., MD</creatorcontrib><creatorcontrib>Bleeker, Gabe B., MD, PhD</creatorcontrib><creatorcontrib>Boersma, Eric, PhD</creatorcontrib><creatorcontrib>Schalij, Martin J., MD, PhD</creatorcontrib><creatorcontrib>Bax, Jeroen J., MD, PhD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ypenburg, Claudia, MD</au><au>van Bommel, Rutger J., MD</au><au>Delgado, Victoria, MD</au><au>Mollema, Sjoerd A., MD</au><au>Bleeker, Gabe B., MD, PhD</au><au>Boersma, Eric, PhD</au><au>Schalij, Martin J., MD, PhD</au><au>Bax, Jeroen J., MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Optimal Left Ventricular Lead Position Predicts Reverse Remodeling and Survival After Cardiac Resynchronization Therapy</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>2008-10-21</date><risdate>2008</risdate><volume>52</volume><issue>17</issue><spage>1402</spage><epage>1409</epage><pages>1402-1409</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><abstract>Objectives The aim of the current study was to evaluate echocardiographic parameters after 6 months of cardiac resynchronization therapy (CRT) as well as long-term outcome in patients with the left ventricular (LV) lead positioned at the site of latest activation (concordant LV lead position) as compared with that seen in patients with a discordant LV lead position. Background A nonoptimal LV pacing lead position may be a potential cause for nonresponse to CRT. Methods The site of latest mechanical activation was determined by speckle tracking radial strain analysis and related to the LV lead position on chest X-ray in 244 CRT candidates. Echocardiographic evaluation was performed after 6 months. Long-term follow-up included all-cause mortality and hospitalizations for heart failure. Results Significant LV reverse remodeling (reduction in LV end-systolic volume from 189 ± 83 ml to 134 ± 71 ml, p < 0.001) was noted in the group of patients with a concordant LV lead position (n = 153, 63%), whereas patients with a discordant lead position showed no significant improvements. In addition, during long-term follow-up (32 ± 16 months), less events (combined for heart failure hospitalizations and death) were reported in patients with a concordant LV lead position. Moreover, a concordant LV lead position appeared to be an independent predictor of hospitalization-free survival after long-term CRT (hazard ratio: 0.22, p = 0.004). Conclusions Pacing at the site of latest mechanical activation, as determined by speckle tracking radial strain analysis, resulted in superior echocardiographic response after 6 months of CRT and better prognosis during long-term follow-up.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>18940531</pmid><doi>10.1016/j.jacc.2008.06.046</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Cardiac arrhythmia Cardiac Pacing, Artificial - methods Cardiology Cardiovascular Cardiovascular disease Drug therapy echocardiography Echocardiography, Doppler Electrodes, Implanted Female Forecasting Heart attacks Heart failure Heart Failure - diagnostic imaging Heart Failure - therapy Heart Ventricles - diagnostic imaging Heart Ventricles - physiopathology Hospitalization Humans Internal Medicine lead position Male Medical prognosis Middle Aged Ostomy Pacemaker, Artificial resynchronization therapy Severity of Illness Index Stroke Volume Studies Survival Analysis Time Factors Tomography Treatment Outcome Ventricular Remodeling |
| title | Optimal Left Ventricular Lead Position Predicts Reverse Remodeling and Survival After Cardiac Resynchronization Therapy |
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