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The incidence and outcomes of delayed response to cardiac resynchronization therapy

Byline: Kebei Li, Zhiyong Qian, Xiaofeng Hou, Yao Wang, Yuanhao Qiu, Yufeng Sheng, Xuesong Qian, Yong Zhou, Jiangang Zou Keywords: cardiac resynchronization therapy; delayed response; mortality; scar burden Abstract Background The incidence and clinical outcomes of delayed response to cardiac resync... Full description

Journal Title: Pacing and Clinical Electrophysiology January 2018, Vol.41(1), pp.73-80
Main Author: Li, Kebei
Other Authors: Qian, Zhiyong , Hou, Xiaofeng , Wang, Yao , Qiu, Yuanhao , Sheng, Yufeng , Qian, Xuesong , Zhou, Yong , Zou, Jiangang
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ID: ISSN: 0147-8389 ; E-ISSN: 1540-8159 ; DOI: 10.1111/pace.13252
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title: The incidence and outcomes of delayed response to cardiac resynchronization therapy
format: Article
creator:
  • Li, Kebei
  • Qian, Zhiyong
  • Hou, Xiaofeng
  • Wang, Yao
  • Qiu, Yuanhao
  • Sheng, Yufeng
  • Qian, Xuesong
  • Zhou, Yong
  • Zou, Jiangang
subjects:
  • Cardiac Resynchronization Therapy
  • Delayed Response
  • Mortality
  • Scar Burden
ispartof: Pacing and Clinical Electrophysiology, January 2018, Vol.41(1), pp.73-80
description: Byline: Kebei Li, Zhiyong Qian, Xiaofeng Hou, Yao Wang, Yuanhao Qiu, Yufeng Sheng, Xuesong Qian, Yong Zhou, Jiangang Zou Keywords: cardiac resynchronization therapy; delayed response; mortality; scar burden Abstract Background The incidence and clinical outcomes of delayed response to cardiac resynchronization therapy (CRT) have not been well clarified. We aimed to observe the incidence and prognosis of delayed response and to identify its possible mechanisms. Methods A total of 115 CRT patients were retrospectively analyzed in our study. Patients who met the enrollment criteria were divided into two groups: group A, conventional responders who showed response at 1-year follow-up, and group B, delayed responders who showed response after 1-year follow-up. CRT response was defined as an absolute increase of AaAaAeAc[yen]10% in left ventricul ejection fraction. Results Fifty-two patients (61 [+ or -] 12 years, 37 male) experienced conventional response to CRT and 17 patients (63 [+ or -] 11 years, 10 male) experienced delayed response. The mean follow-up time was 5.2 [+ or -] 2.4 years. The incidence of delayed response was 14.8% (17/115). All-cause mortality and hospitalization rates for heart failure were similar for delayed and conventional responders. Multivariate logistic regression analysis revealed that scar burden > 35% was an independent predictor of CRT delayed response (odds ratio 8.794, P = 0.038). Conclusions A significant proportion of patients demonstrated delayed response to CRT. The delayed responders had a good prognosis that was similar to that of conventional responders. More scar burden might be related to the incidence of delayed response. Article Note: Kebei Li and Zhiyong Qian contributed equally to this study. Funding This study was supported by a grant from Science and Technology Department of Jiangsu Province (Project Number: BE2016764, PI: Jiangang Zou). CAPTION(S): File S1. Serial echocardiographic changes. This line chart shows left ventricular ejection fraction (LVEF, a) and Left ventricular end diastolic diameter (LVEDD, b) changes before CRT implantation and during the follow-up. Comparisons with non-responders: *p < 0.05. Comparisons with baseline: +p < 0.05 File S2. Kaplan-Meier survival curves of all-cause mortality(a) and hospitalization(b) for heart failure File S3. Baseline features of responders and non-responders File S4. CRT response using three different criteria
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identifier: ISSN: 0147-8389 ; E-ISSN: 1540-8159 ; DOI: 10.1111/pace.13252
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issn:
  • 0147-8389
  • 01478389
  • 1540-8159
  • 15408159
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titleThe incidence and outcomes of delayed response to cardiac resynchronization therapy
creatorLi, Kebei ; Qian, Zhiyong ; Hou, Xiaofeng ; Wang, Yao ; Qiu, Yuanhao ; Sheng, Yufeng ; Qian, Xuesong ; Zhou, Yong ; Zou, Jiangang
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descriptionByline: Kebei Li, Zhiyong Qian, Xiaofeng Hou, Yao Wang, Yuanhao Qiu, Yufeng Sheng, Xuesong Qian, Yong Zhou, Jiangang Zou Keywords: cardiac resynchronization therapy; delayed response; mortality; scar burden Abstract Background The incidence and clinical outcomes of delayed response to cardiac resynchronization therapy (CRT) have not been well clarified. We aimed to observe the incidence and prognosis of delayed response and to identify its possible mechanisms. Methods A total of 115 CRT patients were retrospectively analyzed in our study. Patients who met the enrollment criteria were divided into two groups: group A, conventional responders who showed response at 1-year follow-up, and group B, delayed responders who showed response after 1-year follow-up. CRT response was defined as an absolute increase of AaAaAeAc[yen]10% in left ventricul ejection fraction. Results Fifty-two patients (61 [+ or -] 12 years, 37 male) experienced conventional response to CRT and 17 patients (63 [+ or -] 11 years, 10 male) experienced delayed response. The mean follow-up time was 5.2 [+ or -] 2.4 years. The incidence of delayed response was 14.8% (17/115). All-cause mortality and hospitalization rates for heart failure were similar for delayed and conventional responders. Multivariate logistic regression analysis revealed that scar burden > 35% was an independent predictor of CRT delayed response (odds ratio 8.794, P = 0.038). Conclusions A significant proportion of patients demonstrated delayed response to CRT. The delayed responders had a good prognosis that was similar to that of conventional responders. More scar burden might be related to the incidence of delayed response. Article Note: Kebei Li and Zhiyong Qian contributed equally to this study. Funding This study was supported by a grant from Science and Technology Department of Jiangsu Province (Project Number: BE2016764, PI: Jiangang Zou). CAPTION(S): File S1. Serial echocardiographic changes. This line chart shows left ventricular ejection fraction (LVEF, a) and Left ventricular end diastolic diameter (LVEDD, b) changes before CRT implantation and during the follow-up. Comparisons with non-responders: *p < 0.05. Comparisons with baseline: +p < 0.05 File S2. Kaplan-Meier survival curves of all-cause mortality(a) and hospitalization(b) for heart failure File S3. Baseline features of responders and non-responders File S4. CRT response using three different criteria
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