Background
Methods
Echocardiography
Definition of CRT response
Statistical analyses
Results
All patients (n = 202) | BNP reduction < 25% (n = 78) | BNP reduction ≥ 25% (n = 124) | P-value | |
---|---|---|---|---|
Male gender | 157 (78%) | 61 (78%) | 96 (77%) | 1.0 |
Age, (years) (median IQR) | 71 (14) | 72 (14) | 69 (13) | 0.14 |
LV ejection fraction (mean ± SD) | 27 ± 7 | 27 ± 6 | 27 ± 8 | 0.92 |
LVESV (mean ± SD) | 158 ± 68 | 148 ± 73 | 164 ± 65 | 0.09 |
QRS duration (ms, median IQR) | 161 ± 23 | 154 ± 23 | 166 ± 22 | < 0.001 |
Ischemic cardiomyopathy | 100 (50%) | 38 (49%) | 62 (50%) | 0.89 |
Hypertension | 121 (60%) | 47 (60%) | 74 (60%) | 1.0 |
Diabetes | 50 (25%) | 21 (27%) | 29 (23%) | 0.62 |
Atrial Fibrillation | 91 (45%) | 37 (47%) | 54 (44%) | 0.66 |
Previous CABG | 52 (26%) | 22 (28%) | 30 (24%) | 0.62 |
LBBB | 129 (64%) | 42 (54%) | 87 (70%) | 0.02 |
LBBB > 150 msec | 148 (73%) | 46 (59%) | 102 (82%) | 0.01 |
NYHA class III-IV | 151 (75%) | 55 (71%) | 96 (77%) | 0.32 |
ACEi or ARB use | 179 (89%) | 69 (89%) | 110 (89%) | 1.0 |
Loop diuretic use | 147 (73%) | 60 (77%) | 87 (70%) | 0.33 |
Anticoagulant use | 91 (45%) | 34 (44%) | 57 (46%) | 0.77 |
Digoxin use | 27 (13%) | 12 (15%) | 15 (12%) | 0.53 |
Beta-blocker use | 176 (87%) | 65 (83%) | 111 (90%) | 0.28 |
Creatinine pre implant (mg/dl) | 1.12 (0.45) | 1.20 (0.52) | 1.08 (0.44) | 0.05 |
CRT-D vs. CRT-Pacemaker | 169 (84%) | 63 (81%) | 106 (86%) | 0.44 |
NT-proBNP baseline (ng/L median IQR) | 1554 (3393) | 1444 (3770) | 1661 (2968) | 0.31 |
Parameters for prediction of clinical outcome
“CRT response score”
Univariate analysis | Multivariate analysisa | |||||
---|---|---|---|---|---|---|
P-value | HR | 95% C.I. | P-value | HR | 95% C.I. | |
Female gender | 0.12 | 0.44 | 0.15–1.2 | 0.24 | 0.59 | 0.24–1.4 |
Age, years (median IQR) | 0.03 | 1.04 | 1.0–1.08 | 0.4 | 1.01 | 0.98–1.0 |
Ischemic cardiomyopathy | 0.5 | 1.3 | 0.64–2.5 | 0.33 | 1.4 | 0.71–2.8 |
LV ejection fraction, (%) | 0.67 | 0.99 | 0.94–1.04 | 0.03 | 0.69 | 0.50–0.96 |
Hypertension | 0.79 | 1.1 | 0.55–2.2 | |||
Diabetes | 0.34 | 1.4 | 0.69–3.0 | |||
History of atrial Fibrillation | 0.22 | 1.5 | 0.78–3.0 | |||
QRS duration | 0.32 | 0.99 | 0.98–1.0 | |||
Left bundle branch block | 0.1 | 0.57 | 0.29–1.1 | 0.03 | 0.51 | 0.28–0.93 |
ACEi or ARB use | 0.5 | 0.72 | 0.28–1.9 | |||
Loop diuretic use | 0.34 | 1.5 | 0.66–3.5 | |||
Beta-blocker use | 0.4 | 1.7 | 0.51–5.4 | |||
Creatinine pre implant | 0.49 | 1.1 | 0.83–1.5 | |||
CRT-P (compared to CRT-D) | 0.02 | 2.4 | 1.2–5.1 | 0.21 | 1.6 | 0.78–3.2 |
NT-proBNP baseline (per 100 ng/L) | 0.02 | 1.01 | 1.001–1.009 | |||
NYHA class baseline | 0.52 | 0.85 | 0.52–1.4 | |||
Composite score (per point) | < 0.0001 | 0.52 | 0.36–0.74 | 0.03 | 0.69 | 0.50–0.96 |