1. The 28th Great Wall International Congress of Cardiology
E-POSTER
GW28 – e0318
Title: Factors Associated With Super-Response To Cardiac Resynchronisation Therapy
Author: Anna Soldatova
Institute: Tyumen Cardiology Research Center
Biography: Anna Soldatova works in Tyumen Cardiology Research Center as a scientific researcher since 2012, received PhD in Since January 2015 the head of Young researchers Society in Tyumen Cardiology Center, an organizer of Young investigator award competition within the annual International congress «Cardiology at a crossroad of sciences» (Tyumen, Russia). The main research interests and activity are in the field of heart failure, echocardiography and cardiac resynchronisation therapy. Сo-author of 118 publications, 15 theses in Web of Science, patent of invention «Prediction of superresponse to cardiac resynchronization therapy».
Objectives: Data from some recent studies suggest that left bundle brunch block (LBBB), wide QRS complex, presence of mechanical dyssynchrony are associated with good response to cardiac resynchronisation therapy (CRT). However, it is not clear if these parameters could accurately predict superresponse to CRT. The aim was to evaluate potential predictors related to superresponse after CRT and to analyze the mortality in patients with different response to CRT.
Methods: 60 CRT patients (mean age 54.3±9.8 years; 80% men) with congestive heart failure (CHF) II-IV NYHA functional class were enrolled. At baseline, 1 month, 3 months and each 6 months after implantation clinical, electrocardiographic and echocardiographic parameters, NT-proBNP level were evaluated. According to the best decrease of left ventricular end-systolic volume (LVESV) (mean follow-up period 33.7±15.1 months) patients were classified as super-responders (SR) (n=28; reduction in LVESV ≥30%; best response in 29.0[12.3;35.8] months) and non-SR (n=32; reduction in LVESV <30%; best response in 9.0[1.4;12.3] months).
Results: At baseline groups differed in age (p=0.003), gender (p=0.028), width of QRS complex (p=0.044). Percentage of LBBB was equal between groups (p=0.274). All parameters of mechanical dyssynchrony were higher in SR, but only the difference in left ventricular pre-ejection period (LVPEP) was statistically significant (p=0.032) (Fig.1).
Conclusions: Super-response to CRT is associated with better survival in long-term period. Presence of LBBB was not associated with super-response. LVPEP, NT-proBNP level and age at baseline can be used as independent predictors of CRT super-response.
During the follow-up period both groups demonstrated significant increase in LVEF and reduction in LVESV and NT-proBNP. However, these changes were significantly greater in SR (Fig.2). The survival rates were 100% in SR and 90.6% in non-SR (log-rank test P=0.002) (Fig.3).
- p<0.05 between groups *
Multiple logistic regression analysis showed that LVPEP (HR 1.024; 95% CI 1.004–1.044; P=0.017), baseline NT-proBNP level (HR 0.628; 95% CI 0.414–0.953; P=0.029) and age at baseline (HR 1.094; 95% CI ; P=0.030) were independent predictors for CRT superresponse.
P=0.004
P=0.001
Log-rank test P=0.002
Sensitivity 71.9%
Specificity 82.1%
AUC=0.827; p<0.001
pg/ml
- p<0.05 between groups