Background
Methods
Study protocol
Galectin-3
CRT device implantation
Response to CRT and outcomes
Statistical analyses
Results
Characteristics of patients
All (N = 61) | Responders (N = 49) | Non-responders (N = 12) |
p*
| |
---|---|---|---|---|
Age (years) | 61 ± 5 | 61 ± 5 | 64 ± 7 | 0.23 |
Female sex (%) | 17 (28%) | 14 (29%) | 3 (25%) | 0.80 |
CAD | 25 (41%) | 18 (37%) | 7 (58%) | 0.16 |
Gal-3 (ng/mL) | 17 ± 6 | 16 ± 6 | 19 ± 8 | 0.13 |
CRP (mg/L) | 7 ± 11 | 8 ± 12 | 6 ± 6 | 0.53 |
Baseline Minnesota | 30 ± 19 | 29 ± 18 | 34 ± 23 | 0.47 |
6 months Minnesota | 15 ± 14 | 15 ± 14 | 16 ± 18 | 0.90 |
Baseline NYHA class | ||||
NYHA II | 28 (46%) | 22 | 6 | 0.75 |
NYHA III | 33 (54%) | 27 | 6 | 0.75 |
6 months NYHA class | ||||
NYHA I | 36 (59%) | 36 | 0 |
<
0.001
|
NYHA II | 25 (40%) | 13 | 12 |
<
0.001
|
Baseline LVEF (%) | 27 ± 5 | 27 ± 6 | 27 ± 5 | 0.91 |
6 months LVEF (%) | 39 ± 8 | 41 ± 7 | 32 ± 7 |
<
0.001
|
LVESV (mL/m2) | 72 ± 26 | 73 ± 26 | 69 ± 27 | 0.65 |
Presence of LGE | 26 (43%) | 17 (35%) | 9 (75%) |
0.01
|
LGE + number of segments | 2.2 ± 3.3 | 1.9 ± 3.4 | 3.5 ± 2.9 | 0.15 |
Percentage of LGE (%) | 11 ± 15 | 8 ± 13 | 22 ± 16 |
0.006
|
QRS before CRT (ms) | 163 ± 19 | 163 ± 21 | 165 ± 13 | 0.64 |
QRS after CRT (ms) | 135 ± 18 | 135 ± 20 | 136 ± 13 | 0.81 |
Selvester scoring (%) | 17 ± 9 | 17 ± 9 | 19 ± 10 | 0.63 |
Creatinine clearance (mL/min/1.73 m2) | 75 ± 23 | 77 ± 22 | 71 ± 27 | 0.40 |
Diabetes | 21 (34%) | 14 | 7 | 0.06 |
Basal (N = 32) | Mid (N = 21) | Apical (N = 8) | |
---|---|---|---|
Antero-lateral (N = 27) | 20 (33%) | 7 (11%) | 0 |
Lateral (N = 27) | 12 (20%) | 12 (20%) | 3 (5%) |
Infero-lateral (N = 7) | 0 | 2 (3%) | 5 (8%) |
All (N = 61) | Responders (N = 49) | Non-responders (N = 12) |
p*
| |
---|---|---|---|---|
ß-blockers | 55 (90%) | 45 (92%) | 10 (83%) | 0.40 |
ACE or ARB | 61 (100%) | 49 (100%) | 12 (100%) | – |
MRA | 43 (70%) | 36 (73%) | 7 (58%) | 0.31 |
Diuretics | 46 (75%) | 37 (76%) | 9 (76%) | 0.97 |
Anticoagulant | 6 (10%) | 5 (10%) | 1 (8%) | 0.84 |
Antiplatelet therapy | 38 (62%) | 20 (41%) | 9 (75%) | 0.30 |
Predictive parameters of response to CRT
Univariate OR [CI 95%] |
p*
| Multivariable OR [CI 95%] |
p*
| |
---|---|---|---|---|
Age ≥ 65 year-old | 0.42 [0.09–1.99] | 0.29 | ||
CAD | 0.41 [0.11–1.50] | 0.18 | ||
Female sex | 1.20 [0.28–5.10] | 0.80 | ||
Minnesota ≥ 46 | 0.42 [0.10–1.82] | 0.26 | ||
Gal-3 ≥ 22 (ng/mL) | 0.27 [0.07–1.08] | 0.07 | 0.11 [0.02–0.40] |
<
0.001
|
LVEF ≥ 25% | 1.03 [0.24–4.43] | 0.97 | ||
LVESV (mL/m2) | 0.59 [0.97–1.02] | 0.65 | ||
Presence of LGE | 0.18 [0.04–0.74] |
0.01
| ||
LGE ≥ 14% | 0.13 [0.03–0.57] |
0.003
| 0.17 [0.03–0.62] |
0.007
|
QRS < 150 ms | 1.83 [0.20–16.51] | 0.57 | ||
Selvester ≥ 24% | 0.65 [0.17–2.54] | 0.54 | ||
Creatinine clearance (mL/min/1.73 m2) | 0.99 [0.96–1.02] | 0.40 | ||
Diabetes | 0.29 [0.08–1.05] | 0.06 | 0.16 [0.04–0.64] |
0.008
|
Outcomes
Univariate HR [CI 95%] |
p*
| Multivariate HR [CI 95%] |
p*
| |
---|---|---|---|---|
Age ≥ 65 year-old | 1.89 [0.29–7.37] | 0.45 | ||
CAD | 3.62 [1.07–16.41] |
0.04
| 2.64 [0.72–12.54] | 0.15 |
Female sex | 0.86 [0.19–2.89] | 0.82 | ||
Minnesota ≥ 46 | 0.71 [0.22–2.72] | 0.59 | ||
Gal-3 ≥ 22 (ng/mL) | 4.33 [1.34–14.01] |
0.02
| 3.31 [1.00–11.34] |
0.05
|
LVEF ≥ 25% | 0.54 [0.17–1.85] | 0.31 | ||
LVESV (mL/m2) | 5.54 [0.53–43.11] | 0.14 | ||
Presence of LGE | 2.31 [0.73–8.67] | 0.16 | ||
LGE ≥ 14% | 2.20 [0.70–7.45] | 0.17 | ||
QRS < 150 ms | 3.20 [0.69–11.31] | 0.12 | ||
Selvester ≥ 24% | 1.84 [0.49–5.89] | 0.34 | ||
Creatinine clearance (mL/min/1.73 m2) | 0.98 [0.95–1.02] | 0.12 | ||
Diabetes | 1.24 [0.39–4.68] | 0.71 |