What can we learn from hyper-responders to cardiac resynchronisation therapy (CRT)? Characteristics and predictors of super response to CRT. An Algerian single centre experience - 09/01/21
, M.S. Ait Messaoudene, Y. Aoudia, A. Boudrifa, K. Bouasria, Y. Tir, O. Kassoul, H. Elnajer, L. Ouabdeslem, N. Ali Tatar, M.T. Chentir, Y. Bouhouita
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Résumé |
Introduction |
In some patients with dilated cardiomyopathy (DCM) and left bundle branch block (LBBB), cardiac resynchronisation therapy (CRT) has been shown to reverse almost completely left ventricular (LV) function.
Purpose |
Determine the proportion of super responders among patients with DCM and attempt to determine their profile.
Methods |
Consecutive patients with DCM (LV ejection fraction (LVEF)<35%, LV end-diastolic diameter>60mm) and LBBB implanted with a CRT were prospectively followed. Patients were considered super-responders if they fulfilled two criteria: class NYHA I/II and LVEF≥50%.
Results |
Among the 98 DCM patients, 19 (19.5%) were found to be super-responders following CRT (LVEF increased from 29.89±4.44 to 53.37±3.76%, P<0.001). In the 79 (81%) remaining patients, there was a significant increase in LVEF from 26.49±4.67 to 37.27±7.20, P<0.001). At baseline, there were no significant differences between super-responders and other patients, except that super-responders were female, had no hospitalisation for heart failure before implantation and no renal deficiency. Super responders had also less severe LVEF and lower pulmonary artery systolic pressure. CRT-P (OR: 5.47; 95% CI: 1.48–20.27; P=0.007), lower left ventricular end-diastolic dimension (OR: 0.97; 95% CI: 0.95–0.0.99; P=0.0002) and lower pulmonary artery systolic pressure (OR: 0.92; 95% CI: 0.87, 0.96; P<0.001) were independent predictors of super-response to CRT (see Table 1).
Conclusion |
Among patients with DCM and LBBB, Patients in earlier phases of the cardiomyopathy, with a less altered ventricular geometry, seem to have a greater probability of becoming super-responders.
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Vol 13 - N° 1
P. 85-86 - janvier 2021 Retour au numéro
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