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Interaction of left ventricular size with the outcome of cardiac resynchronization therapy in Japanese patients.
Ito, Ryo; Kondo, Yusuke; Nakano, Masahiro; Kajiyama, Takatsugu; Nakano, Miyo; Kitagawa, Mari; Sugawara, Masafumi; Chiba, Toshinori; Kobayashi, Yoshio.
Afiliación
  • Ito R; Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
  • Kondo Y; Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
  • Nakano M; Department of Advanced Cardiorhythm Therapeutics, Chiba University Graduate School of Medicine, Chiba, Japan.
  • Kajiyama T; Department of Advanced Cardiorhythm Therapeutics, Chiba University Graduate School of Medicine, Chiba, Japan.
  • Nakano M; Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
  • Kitagawa M; Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
  • Sugawara M; Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
  • Chiba T; Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
  • Kobayashi Y; Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
Clin Cardiol ; 47(4): e24267, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38619004
ABSTRACT

BACKGROUND:

We analyzed the influence of the QRS duration (QRSd) to LV end-diastolic volume (LVEDV) ratio on cardiac resynchronization therapy (CRT) outcomes in heart failure patients classified as III/IV per the New York Heart Association (NYHA) and with small body size.

HYPOTHESIS:

We proposed the hypothesis that the QRSd/LV size ratio is a better index of the CRT substrate.

METHODS:

We enrolled 114 patients with advanced heart failure (NYHA class III/IV, and LV ejection fraction >35%) who received a CRT device, including those with left bundle branch block (LBBB) and QRSd ≥120 milliseconds (n = 60), non-LBBB and QRSd ≥150 milliseconds (n = 30) and non-LBBB and QRSd of 120-149 milliseconds (n = 24).

RESULTS:

Over a mean follow-up period of 65 ± 58 months, the incidence of the primary endpoint, a composite of all-cause death and hospitalization for heart failure, showed no significant intergroup difference (43.3% vs. 50.0% vs. 37.5%, respectively, p = .72). Similarly, among 104 patients with QRSd/LVEDV ≥ 0.67 (n = 54) and QRSd/LVEDV < 0.67 (n = 52), no significant differences were observed in the incidence of the primary endpoint (35.1% vs. 51.9%, p = .49). Nevertheless, patients with QRSd/LVEDV ≥ 0.67 showed better survival than those with QRSd/LVEDV < 0.67 (14.8% vs. 34.6%, p = .0024).

CONCLUSION:

Advanced HF patients with a higher QRSd/LVEDV ratio showed better survival in this small-body-size population. Thus, the risk is concentrated among those with a larger QRSd, and patients with a relatively smaller left ventricular size appeared to benefit from CRT.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Terapia de Resincronización Cardíaca / Insuficiencia Cardíaca Límite: Humans País/Región como asunto: Asia Idioma: En Revista: Clin Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Terapia de Resincronización Cardíaca / Insuficiencia Cardíaca Límite: Humans País/Región como asunto: Asia Idioma: En Revista: Clin Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos