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Journal of Cardiovascular Translational Research

Erschienen in:

01.04.2012

Acute and Chronic Response to CRT in Narrow QRS Patients

verfasst von: Tim Donahue, Imran Niazi, Angel Leon, Michael Stucky, Keith Herrmann, on behalf of the ESTEEM-CRT Investigators

Erschienen in: Journal of Cardiovascular Translational Research | Ausgabe 2/2012

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Abstract

Previous studies suggest that CRT may benefit narrow QRS patients with mechanical dyssynchrony (MD). We conducted an acute and chronic study, evaluating the response of heart failure patients with a narrow QRS to cardiac resynchronization therapy (CRT). ESTEEM-CRT was a multi-center, single-arm, feasibility study that evaluated ICD-indicated, medically-optimized patients with EF ≤ 35%, NYHA class III heart failure, QRS duration <120 ms, and MD as defined by the standard deviation of time to peak systolic velocity of 12 segments (Ts-SD). Sixty-eight patients received a CRT defibrillator, exercise testing, and echo exams, and 47 of these patients underwent invasive hemodynamic testing at implant. Follow-up was at 6 and 12 months. The average maximal improvement in LV dP/dt_max was minor (2 ± 2%). NYHA and quality of life scores were substantially improved at 6 and 12 months (P < 0.001), while exercise capacity and LV volumes were unchanged. The echo indices of MD were difficult to collect, discordant, and failed to predict clinical outcomes. ESTEEM-CRT patients with a narrow QRS and MD as defined in this study did not improve as measured by acute hemodynamics, chronic exercise performance, or reverse remodeling. These multi-center results support the notion that dyssynchrony indices are ineffective or at least require greater refinement for the selection of narrow QRS patients for CRT.

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Titel: Acute and Chronic Response to CRT in Narrow QRS Patients
verfasst von: Tim Donahue
Imran Niazi
Angel Leon
Michael Stucky
Keith Herrmann
on behalf of the ESTEEM-CRT Investigators
Publikationsdatum: 01.04.2012
Verlag: Springer US
Erschienen in: Journal of Cardiovascular Translational Research / Ausgabe 2/2012
Print ISSN: 1937-5387
Elektronische ISSN: 1937-5395
DOI: https://doi.org/10.1007/s12265-011-9338-3

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Acute and Chronic Response to CRT in Narrow QRS Patients

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