Can echocardiography facilitate decision-making to CRT?
نویسندگان
چکیده
Abstract Introduction Cardiac resynchronization therapy (CRT) remains underused despite its well-established therapeutic effect and clear guidelines. Among various reasons are the lack of referral, fear complications high cost. The assessment mechanical dyssynchrony (MD) on echocardiography has been suggested to aid patient selection. In past, however, several studies have used old markers MD producing disappointing results use for selection became discredited. Promising new developed since could clinical decision-making CRT. These should, first be thoroughly tested compared markers. Purpose (I) To confirm relevance survival free cardiac death (II) compare predicting within 5 years post-CRT in patients eligible CRT according 2021 ESC Methods 222 CRT-patients were analysed retrospectively a multicentre setting. was assessed using three markers: septal-to-posterior wall-motion-delay (SPWMD), left-ventricular-filling-time/cardiac-cycle ratio (LVFT/RR), intraventricular delay (IVMD); systolic stretch index (SSI), myocardial work (MWI), visual presence septal flash or apical rocking (SFoAR). For each marker, categorized previously published cut-offs as “MD present” (Yes) not (No). Log rank tests performed Kaplan-Meier curves death. Cox proportional hazards regressions compute hazard-ratio (HR) after implantation. Results occurred 37 (17%). Patients with before IVMD (p=0.003), SSI (p<0.001), MWI (p<0.001) SFoAR had significantly better survival. hazard ratios 0.34 (95% CI, 0.19–0.75) IVMD, 0.30 0.15–0.57) SSI, 0.26 0.12–0.54) and, 0.28 0.14–0.53) SFoAR. other significant Conclusion than old. 3 4 times less likely die one these broad QRS (≥130ms) reduced LVEF (≤35%) should prompt clinicians refer proceed Funding Acknowledgement Type funding sources: None.
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ژورنال
عنوان ژورنال: European Heart Journal
سال: 2022
ISSN: ['2634-3916']
DOI: https://doi.org/10.1093/eurheartj/ehac544.335