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Low value of simple echocardiographic indices of ventricular dyssynchrony in predicting the response to cardiac resynchronization therapy
Author(s) -
Bordachar Pierre,
Lafitte Stéphane,
Réant Patricia,
Reuter Sylvain,
Clementy Jacques,
Mletzko RalphUwe,
Siegel Robert M.,
GoscinskaBis Kinga,
Bowes Robert,
Morgan John,
Bénard Sandrine,
Leclercq Christophe
Publication year - 2010
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfq058
Subject(s) - medicine , cardiac resynchronization therapy , cardiology , heart failure , ventricular dyssynchrony , ejection fraction
Aims A recent study suggested that no single echocardiographic index of cardiac dyssynchrony can reliably identify candidates for cardiac resynchronization therapy (CRT). We examined the value of three simple echocardiographic indices for predicting the 6‐month clinical and echocardiographic responses to CRT. Methods and results We analysed data from 75 CRT‐D system recipients. Standard echocardiography was used to measure aortic pre‐ejection delay (APED), interventricular mechanical delay (IVMD), and delayed activation of the left ventricular (LV) infero‐lateral wall (OVERLAP). Clinical responders were defined as patients who had an improved status, based on rehospitalization for heart failure, NYHA class, and peak oxygen consumption. Echocardiographic responders had a ≥10% decrease in LV end‐systolic volume. During the study, one patient died and five were lost to follow‐up. Of the remaining 69 analysable patients, 50 (72.5%) were classed as clinical responders and 41 (59.4%) as echocardiographic responders to CRT. Before CRT implantation, APED, IVMD, and OVERLAP were similar in responders and non‐responders. The value of these indices of dyssynchrony as single or combined predictors of the clinical or echocardiographic response to CRT was low, with sensitivities ranging between 4 and 63%, and specificities between 37 and 100%. Conclusion Simple echocardiographic indices of dyssynchrony were poor predictors of response to CRT.