Vol 22, No 2 (2015)
Original articles
Published online: 2015-04-28

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A new score system for predicting response to cardiac resynchronization therapy

Yu Kang, Leilei Cheng, Jie Cui, Lin Li, Shengmei Qin, Yangang Su, Jialiang Mao, Xue Gong, Haiyan Chen, Cuizhen Pan, Xuedong Shen, Ben He, Xianhong Shu
DOI: 10.5603/CJ.a2014.0089
Pubmed: 25428735
Cardiol J 2015;22(2):179-187.

Abstract

Background: The aim of this study was to establish a score system derived from clinical, echocardiographic and electrocardiographic indexes and evaluate its clinical value for cardiac resynchronization therapy (CRT) patient selection.

Methods: Ninety-three patients receiving CRT were enrolled. A patient selection score system was generated by the clinical, echocardiographic and electrocardiographic parameters achieving a significant level by univariate and multivariate Cox regression model. The positive response to CRT was a left ventricular end systolic volume decrease of ≥ 15% and not reaching primary clinical endpoint (death or re-hospitalization for heart failure) at the end of follow-up.

Results: Thirty-nine patients were CRT non-responders (41.94%) and 54 were responders (58.06%). A 4-point score system was generated based on tricuspid annular plane systolic ex­cursion (TAPSE), longitudinal strain (LS), and complete left bundle branch block (CLBBB) combined with a wide QRS duration (QRSd). The sensitivity and specificity for prediction of a positive response to CRT at a score > 2 were 0.823 and 0.850, respectively (AUC: 0.92295% CI 0.691–0.916, p< 0.001).

Conclusions: A patient selection score system based on the integration of TAPSE, LS and CLBBB combined with a wide QRSd can help to predict positive response to CRT effectively and reliably.