Prediction of response to cardiac resynchronization therapy: The selection of candidates for CRT (SCART) study
Prediction of response to cardiac resynchronization therapy: The selection of candidates for CRT (SCART) study
复制标题
DOI：
10.1111/j.1540-8159.2006.00486.x
复制
发表时间：
2006-12-01
影响因子：
1.8
通讯作者：
Puglisi, Andrea
中科院分区：
文献类型：
--
作者：
Achilli, Augusto;Peraldo, Carlo;Puglisi, Andrea
背景资料：本研究的目的是评估基线临床和超声心动图参数预测CRT阳性反应的能力。方法：我们分析了6个月的数据，从第一个133例连续入组的多中心前瞻性研究。这些患者患有药物治疗难治性症状性心力衰竭（HF）（NYHA II-IV级），左心室射血分数（LVEF）= 5个单位。一项多变量分析发现，较小的LVESD（OR = 0.957，95% CI 0.920 - 0.996; P = 0.030）和较长的室间机械延迟（IVMD）（OR = 1.017，95% CI 1.005 - 1.029，P = 0.007）是阳性反应的独立预测因素。受者工作曲线分析表明，IVMD> 44 ms的患者可预测CRT的阳性反应（灵敏度为66%，特异性为55%）或LVESD <60 mm（敏感性为66%，特异性为61%）。我们的研究结果证实了QRS时限在选择CRT患者中的有限价值。晚期疾病和超声心动图室间不同步的证据被证明可以预测CRT的反应，而心室内不同步不能预测反应。
Background: The aim of this study was to evaluate the ability of baseline clinical and echocardiographic parameters to predict a positive response to CRT.Methods: We analyzed 6-month data from the first 133 consecutive patients enrolled in a multicenter prospective study. These patients had symptomatic heart failure (HF) refractory to pharmacological therapy (NYHA class II-IV), left ventricular ejection fraction (LVEF) = 5 units. A multivariate analysis identified that a smaller LVESD (OR = 0.957, 95% CI 0.920-0.996; P = 0.030) and longer interventricular mechanical delay (IVMD) (OR = 1.017, 95% CI 1.005-1.029, P = 0.007) as independent predictors of a positive response. Receiver-operating curve analysis showed that a positive response to CRT may be predicted in patients with IVMD > 44 ms (with a sensitivity of 66% and a specificity of 55%) or with LVESD < 60 mm (with a sensitivity of 66% and a specificity of 61%).Conclusions: Our results confirm the limited value of QRS duration in the selection of patients for CRT.A less-advanced stage of disease and echocardiographic evidence of interventricular dyssynchrony demonstrated to predict response to CRT, while intraventricular dyssynchrony did not predict response.