Echocardiographic measures of acute haemodynamic response after cardiac resynchronization therapy predict long-term clinical outcome
Aims Although acute haemodynamic improvement in response to cardiac resynchronization therapy (CRT) is reflective of a favourable cardiac contractile response, there is limited information regarding not only its ability to predict long-term clinical outcome but also cardiac-substrate-specific differ...
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| Veröffentlicht in: | European heart journal 2007-05, Vol.28 (9), p.1143-1148 |
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| creator | Tournoux, Francois B. Alabiad, Chrisfouad Fan, Dali Chen, Annabel A. Chaput, Miguel Heist, Edwin Kevin Mela, Theofanie Mansour, Moussa Reddy, Vivek Ruskin, Jeremy N. Picard, Michael H. Singh, Jagmeet P. |
| description | Aims
Although acute haemodynamic improvement in response to cardiac resynchronization therapy (CRT) is reflective of a favourable cardiac contractile response, there is limited information regarding not only its ability to predict long-term clinical outcome but also cardiac-substrate-specific differences in the prognostic value of this measure.
Methods and results
Fifty-three heart failure patients (69 ± 11 years) with low left ventricle ejection fraction (LVEF) (22 ± 6%), wide QRS (169 ± 31 ms), and indications for CRT were included. There were no significant differences in age, New York Heart Association (NYHA) class, medications, QRS width, or LVEF between ischaemic (n = 37) and non-ischaemic (n = 16) groups. Echocardiograms were performed within 24 h of implantation with device OFF and ON. Acute haemodynamic response was measured as LV dP/dt derived from the CW Doppler of mitral regurgitation. Percentage change in dP/dt was used to classify patients: high- (HR: ΔdP/dt > 25%) or poor-responders (PR: ΔdP/dt ≤ 25%). Clinical response to CRT was defined by a combined endpoint of hospitalizations and all-cause mortality at 12 months. HR group had a significantly better outcome compared to the PR group (P-value = 0.004) irrespective of the aetiology of the cardiomyopathy.
Conclusion
Echocardiographic assessment of the acute haemodynamic response to CRT predicts long-term clinical outcome in both ischaemic and non-ischaemic cardiomyopathy. |
| doi_str_mv | 10.1093/eurheartj/ehm050 |
| format | Article |
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Although acute haemodynamic improvement in response to cardiac resynchronization therapy (CRT) is reflective of a favourable cardiac contractile response, there is limited information regarding not only its ability to predict long-term clinical outcome but also cardiac-substrate-specific differences in the prognostic value of this measure.
Methods and results
Fifty-three heart failure patients (69 ± 11 years) with low left ventricle ejection fraction (LVEF) (22 ± 6%), wide QRS (169 ± 31 ms), and indications for CRT were included. There were no significant differences in age, New York Heart Association (NYHA) class, medications, QRS width, or LVEF between ischaemic (n = 37) and non-ischaemic (n = 16) groups. Echocardiograms were performed within 24 h of implantation with device OFF and ON. Acute haemodynamic response was measured as LV dP/dt derived from the CW Doppler of mitral regurgitation. Percentage change in dP/dt was used to classify patients: high- (HR: ΔdP/dt > 25%) or poor-responders (PR: ΔdP/dt ≤ 25%). Clinical response to CRT was defined by a combined endpoint of hospitalizations and all-cause mortality at 12 months. HR group had a significantly better outcome compared to the PR group (P-value = 0.004) irrespective of the aetiology of the cardiomyopathy.
Conclusion
Echocardiographic assessment of the acute haemodynamic response to CRT predicts long-term clinical outcome in both ischaemic and non-ischaemic cardiomyopathy.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehm050</identifier><identifier>PMID: 17449877</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Aged ; Biological and medical sciences ; Cardiac Pacing, Artificial ; Cardiology. Vascular system ; Cardiovascular system ; Clinical outcomes ; Defibrillators, Implantable ; Echocardiography, Doppler ; Female ; Follow-Up Studies ; Heart ; Heart Failure - diagnostic imaging ; Heart Failure - therapy ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Mitral Valve Insufficiency - etiology ; Myocardial Ischemia - complications ; Myocarditis. Cardiomyopathies ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Treatment Outcome ; Ultrasonic investigative techniques ; Ventricular Dysfunction, Left - diagnostic imaging ; Ventricular Dysfunction, Left - therapy</subject><ispartof>European heart journal, 2007-05, Vol.28 (9), p.1143-1148</ispartof><rights>The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org 2007</rights><rights>2007 INIST-CNRS</rights><rights>The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c498t-4ccdf8c6bd376afce40a8118e536921d684be58b5b2877cd98b04847e169281b3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18767288$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17449877$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tournoux, Francois B.</creatorcontrib><creatorcontrib>Alabiad, Chrisfouad</creatorcontrib><creatorcontrib>Fan, Dali</creatorcontrib><creatorcontrib>Chen, Annabel A.</creatorcontrib><creatorcontrib>Chaput, Miguel</creatorcontrib><creatorcontrib>Heist, Edwin Kevin</creatorcontrib><creatorcontrib>Mela, Theofanie</creatorcontrib><creatorcontrib>Mansour, Moussa</creatorcontrib><creatorcontrib>Reddy, Vivek</creatorcontrib><creatorcontrib>Ruskin, Jeremy N.</creatorcontrib><creatorcontrib>Picard, Michael H.</creatorcontrib><creatorcontrib>Singh, Jagmeet P.</creatorcontrib><title>Echocardiographic measures of acute haemodynamic response after cardiac resynchronization therapy predict long-term clinical outcome</title><title>European heart journal</title><addtitle>Eur Heart J</addtitle><description>Aims
Although acute haemodynamic improvement in response to cardiac resynchronization therapy (CRT) is reflective of a favourable cardiac contractile response, there is limited information regarding not only its ability to predict long-term clinical outcome but also cardiac-substrate-specific differences in the prognostic value of this measure.
Methods and results
Fifty-three heart failure patients (69 ± 11 years) with low left ventricle ejection fraction (LVEF) (22 ± 6%), wide QRS (169 ± 31 ms), and indications for CRT were included. There were no significant differences in age, New York Heart Association (NYHA) class, medications, QRS width, or LVEF between ischaemic (n = 37) and non-ischaemic (n = 16) groups. Echocardiograms were performed within 24 h of implantation with device OFF and ON. Acute haemodynamic response was measured as LV dP/dt derived from the CW Doppler of mitral regurgitation. Percentage change in dP/dt was used to classify patients: high- (HR: ΔdP/dt > 25%) or poor-responders (PR: ΔdP/dt ≤ 25%). Clinical response to CRT was defined by a combined endpoint of hospitalizations and all-cause mortality at 12 months. HR group had a significantly better outcome compared to the PR group (P-value = 0.004) irrespective of the aetiology of the cardiomyopathy.
Conclusion
Echocardiographic assessment of the acute haemodynamic response to CRT predicts long-term clinical outcome in both ischaemic and non-ischaemic cardiomyopathy.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardiac Pacing, Artificial</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular system</subject><subject>Clinical outcomes</subject><subject>Defibrillators, Implantable</subject><subject>Echocardiography, Doppler</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart</subject><subject>Heart Failure - diagnostic imaging</subject><subject>Heart Failure - therapy</subject><subject>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mitral Valve Insufficiency - etiology</subject><subject>Myocardial Ischemia - complications</subject><subject>Myocarditis. Cardiomyopathies</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Treatment Outcome</subject><subject>Ultrasonic investigative techniques</subject><subject>Ventricular Dysfunction, Left - diagnostic imaging</subject><subject>Ventricular Dysfunction, Left - therapy</subject><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc2L1TAUxYMozpvRvSsJgm6kTtImabqUYfyAATcK7kp6ezvNo01qPhZv1v7hZuY9HHDjKpDzO-fe5BDyirMPnHXNJeYwowlpf4nzyiR7QnZc1nXVKSGfkh3jnayU0j_PyHmMe8aYVlw9J2e8FaLTbbsjv69h9mDCaP1tMNtsga5oYg4YqZ-ogZyQzgZXPx6cWYtclM27iNRMCQN98JqH64ODOXhn70yy3tE0Y0k80C3gaCHRxbvbqlhWCot1FsxCfU7gV3xBnk1mifjydF6QH5-uv199qW6-ff569fGmgrJtqgTAOGlQw9i0ykyAghnNuUbZqK7mo9JiQKkHOdTlbTB2emBCixZ5kTUfmgvy7pi7Bf8rY0z9aiPgshiHPse-ZUJ2tVIFfPMPuPc5uLJbX3MpS16jC8SOEAQfY8Cp34JdTTj0nPX39fR_6-mP9RTL61NuHlYcHw2nPgrw9gSYWD5oCsaBjY-cblVb6_vZ74-cz9v_x_4B6yOueQ</recordid><startdate>20070501</startdate><enddate>20070501</enddate><creator>Tournoux, Francois B.</creator><creator>Alabiad, Chrisfouad</creator><creator>Fan, Dali</creator><creator>Chen, Annabel A.</creator><creator>Chaput, Miguel</creator><creator>Heist, Edwin Kevin</creator><creator>Mela, Theofanie</creator><creator>Mansour, Moussa</creator><creator>Reddy, Vivek</creator><creator>Ruskin, Jeremy N.</creator><creator>Picard, Michael H.</creator><creator>Singh, Jagmeet P.</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>IQODW</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>7QP</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20070501</creationdate><title>Echocardiographic measures of acute haemodynamic response after cardiac resynchronization therapy predict long-term clinical outcome</title><author>Tournoux, Francois B. ; Alabiad, Chrisfouad ; Fan, Dali ; Chen, Annabel A. ; Chaput, Miguel ; Heist, Edwin Kevin ; Mela, Theofanie ; Mansour, Moussa ; Reddy, Vivek ; Ruskin, Jeremy N. ; Picard, Michael H. ; Singh, Jagmeet P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c498t-4ccdf8c6bd376afce40a8118e536921d684be58b5b2877cd98b04847e169281b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cardiac Pacing, Artificial</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular system</topic><topic>Clinical outcomes</topic><topic>Defibrillators, Implantable</topic><topic>Echocardiography, Doppler</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart</topic><topic>Heart Failure - diagnostic imaging</topic><topic>Heart Failure - therapy</topic><topic>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mitral Valve Insufficiency - etiology</topic><topic>Myocardial Ischemia - complications</topic><topic>Myocarditis. Cardiomyopathies</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Treatment Outcome</topic><topic>Ultrasonic investigative techniques</topic><topic>Ventricular Dysfunction, Left - diagnostic imaging</topic><topic>Ventricular Dysfunction, Left - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tournoux, Francois B.</creatorcontrib><creatorcontrib>Alabiad, Chrisfouad</creatorcontrib><creatorcontrib>Fan, Dali</creatorcontrib><creatorcontrib>Chen, Annabel A.</creatorcontrib><creatorcontrib>Chaput, Miguel</creatorcontrib><creatorcontrib>Heist, Edwin Kevin</creatorcontrib><creatorcontrib>Mela, Theofanie</creatorcontrib><creatorcontrib>Mansour, Moussa</creatorcontrib><creatorcontrib>Reddy, Vivek</creatorcontrib><creatorcontrib>Ruskin, Jeremy N.</creatorcontrib><creatorcontrib>Picard, Michael H.</creatorcontrib><creatorcontrib>Singh, Jagmeet P.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tournoux, Francois B.</au><au>Alabiad, Chrisfouad</au><au>Fan, Dali</au><au>Chen, Annabel A.</au><au>Chaput, Miguel</au><au>Heist, Edwin Kevin</au><au>Mela, Theofanie</au><au>Mansour, Moussa</au><au>Reddy, Vivek</au><au>Ruskin, Jeremy N.</au><au>Picard, Michael H.</au><au>Singh, Jagmeet P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Echocardiographic measures of acute haemodynamic response after cardiac resynchronization therapy predict long-term clinical outcome</atitle><jtitle>European heart journal</jtitle><addtitle>Eur Heart J</addtitle><date>2007-05-01</date><risdate>2007</risdate><volume>28</volume><issue>9</issue><spage>1143</spage><epage>1148</epage><pages>1143-1148</pages><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Aims
Although acute haemodynamic improvement in response to cardiac resynchronization therapy (CRT) is reflective of a favourable cardiac contractile response, there is limited information regarding not only its ability to predict long-term clinical outcome but also cardiac-substrate-specific differences in the prognostic value of this measure.
Methods and results
Fifty-three heart failure patients (69 ± 11 years) with low left ventricle ejection fraction (LVEF) (22 ± 6%), wide QRS (169 ± 31 ms), and indications for CRT were included. There were no significant differences in age, New York Heart Association (NYHA) class, medications, QRS width, or LVEF between ischaemic (n = 37) and non-ischaemic (n = 16) groups. Echocardiograms were performed within 24 h of implantation with device OFF and ON. Acute haemodynamic response was measured as LV dP/dt derived from the CW Doppler of mitral regurgitation. Percentage change in dP/dt was used to classify patients: high- (HR: ΔdP/dt > 25%) or poor-responders (PR: ΔdP/dt ≤ 25%). Clinical response to CRT was defined by a combined endpoint of hospitalizations and all-cause mortality at 12 months. HR group had a significantly better outcome compared to the PR group (P-value = 0.004) irrespective of the aetiology of the cardiomyopathy.
Conclusion
Echocardiographic assessment of the acute haemodynamic response to CRT predicts long-term clinical outcome in both ischaemic and non-ischaemic cardiomyopathy.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>17449877</pmid><doi>10.1093/eurheartj/ehm050</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; EZB-FREE-00999 freely available EZB journals |
| subjects | Aged Biological and medical sciences Cardiac Pacing, Artificial Cardiology. Vascular system Cardiovascular system Clinical outcomes Defibrillators, Implantable Echocardiography, Doppler Female Follow-Up Studies Heart Heart Failure - diagnostic imaging Heart Failure - therapy Heart failure, cardiogenic pulmonary edema, cardiac enlargement Humans Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Mitral Valve Insufficiency - etiology Myocardial Ischemia - complications Myocarditis. Cardiomyopathies Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Treatment Outcome Ultrasonic investigative techniques Ventricular Dysfunction, Left - diagnostic imaging Ventricular Dysfunction, Left - therapy |
| title | Echocardiographic measures of acute haemodynamic response after cardiac resynchronization therapy predict long-term clinical outcome |
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