Author/Authors :
Reant، نويسنده , , Patricia and Zaroui، نويسنده , , Amira and Donal، نويسنده , , Erwan and Mignot، نويسنده , , Aude and Bordachar، نويسنده , , Pierre and Deplagne، نويسنده , , Antoine and Solnon، نويسنده , , Aude and Ritter، نويسنده , , Philippe and Daubert، نويسنده , , Jean-Claude and Clementy، نويسنده , , Jacques and Leclercq، نويسنده , , Christophe and Roudaut، نويسنده , , Raymond and Habib، نويسنده , , G، نويسنده ,
Abstract :
Cardiac resynchronization therapy (CRT) has been shown to induce a spectacular effect on left ventricular (LV) function in certain patients. Our aim was to analyze and characterize the super-responders (SRs) to CRT using echocardiography in 186 patients with a conventional indication according to the European Society Cardiology guidelines. The investigation took place before and 6 months after implantation. CRT-SRs were defined by an improvement of the New York Heart Association functional class and LV ejection fraction to ≥50% in absolute values associated with a relative LV end-systolic volume reduction of ≥15%. Of the 186 patients, 18 (9.7%) were identified as CRT-SRs and had a significantly lower prevalence of ischemic etiology (11%), lower LV dimensions, lower left atrial volume, and greater global longitudinal strain at baseline. Receiver operating characteristics curves identified global longitudinal strain as the strongest parameter for predicting CRT-SRs, with a cutoff value of −12% (area under the curve 0.87, sensitivity 71%, and specificity 85%, p <0.01). In conclusion, in the present retrospective study, only a left atrial volume <55 ml and global longitudinal strain ≤−12% were independent predictors of CRT-SRs.
