Electrocardiographic predictors of response to cardiac resynchronization therapy of heart failure in patients with dilated cardiomyopathy
Vaĭkhanskaia, T.G.; Kurushko, T.V.; Sidorenko, I.V.; Koptiukh, T.M.; Gul', L.M.; Mel'nikova, O.P.; Golenishcha, V.F.; Kovalenko, O.N.
Kardiologiia 53(3): 48-54
2013
ISSN/ISBN: 0022-9040 PMID: 23548427 Document Number: 668448
The aim of our study was to identify electrocardiographic predictors of response to cardiac resynchronization therapy (CRT) in patients with dilated cardiomyopathy (DCM). 46 patients with DCM (76% men; mean age 48.8+/-12 years; mean NYHA class 3.09+/-0.3; mean QRS duration 167+/-30.1 ms; left ventricular ejection fraction 23.5+/-6%) had CRT implanted. Assessment of clinical, laboratory and echocardiographic (including TDI) and 12-lead surface ECG parameters was performed at baseline, in 24 hours post CRT implantation and after 6 months of follow-up. Multivariate logistic regression analysis selected the following independent predictors of response to CRT: two pre-implantation - baseline RS width in lead V1 ≥ 113.5 ms (OR 0.94, 95% CI 0.814-1.00; p=0.000), BNP ≤ 456 g/ml (OR 0.92, 95% CI 0.797-1.00; p=0.001); and two post-implantation: shortening of QRS width - ΔQRS ≥ -24.5 ms (OR 0.80, 95% CI 0.586-1.00; p=0.01) and shortening of RS V1 width - ΔRSV1 ≥ -21.8 ms (S: 0.87, 95% CI 0.72-1.00; p= 0.002) in 24 hours after CRT.