Evaluation of the long-term effectiveness of cardiac resynchronization therapy

Aim . To determine quantitative criteria for assessing the therapeutic benefits and most informative time frames after cardiac resynchronization therapy (CRT) to assess its long-term effectiveness (1, 2, 3 years of follow-up) based on retrospective analysis. CRT effectiveness, parameters left ventricular (LV) reverse remodeling signs characterizing clinical response were considered. Material methods This single-center, retrospective, non-randomized study included data from 278 patients with implanted devices. Quantitative determined using a two-step cluster analysis 1, by LV parameters. Results In dataset satisfactory division accuracy, first year, two clusters identified, which are conventionally named as “non-responders” “responders”. Two three therapy, classified into clusters: “non-responders”, “responders” “super-responders”. For obtained clusters, we found cutoff values parameters, can be used therapy. The identified postoperative surgery. At same time, is manifested earlier in comparison remodeling. Despite high divisibility responders non-responders, predictive models created available standard diagnostic protocols heart failure have insufficient accuracy making decisions appropriateness. circumstance indicates need receive additional improve forecasting quality. Conclusion revealed period changes surgery, important optimal choice It has been shown that cases, one year surgery sufficient response, process last up average. When remodeling, along change end-systolic volume (ESV), it necessary take account end-diastolic (EDV) changes. ejection fraction showed significantly lower value among analyzed effectiveness. Based classification patients, dividing rule was established non-responders second an 97%: decrease ESV EDV 9% or more compared preoperative values.