Myocardial constructive work is a predictor of long-term outcomes in patients with heart failure undergoing cardiac resynchronization therapy - 25/12/18
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Résumé |
Background |
Recent studies have shown that myocardial constructive work (CW) assessed by pressure strain loops (PSLs) is an independent predictor of cardiac resynchronization therapy response (CRT+).
Purpose of the study |
To assess the role of global myocardial CW in the prediction of long-term outcome of patients undergoing CRT.
Methods |
2D-standard and speckle-tracking echocardiography were performed in 166 CRT candidates (mean age: 66±10 years, males: 69%, QRS duration: 165±19ms) before CRT implantation and at 6-month follow-up. Left-ventricular (LV) end-systolic volume reduction>15% at 6-month follow-up defined CRT+and occurred in 48 (29%) patients.
Results |
After a median FU of 4 years (range: 1.3–5 years), all-cause death occurred in 28 patients (17%), cardiac death in 14 patients (8%). At multivariable Cox-regression analysis, including age, ischemic etiology, septal flash, and CRT+, CW and age were the only prognostic predictors. A CW≤888mmHg% (AUC 0.71, P=0.007 and AUC 0.67, P=0.004 for cardiac and all-cause mortality) was associated with an increased cardiac and all-cause mortality risk.
Conclusions |
The estimation of left-ventricular CW by PSLs curves is a relatively novel tool, which allows the prediction of long-term prognosis in CRT candidates.
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Vol 11 - N° 1
P. 29-30 - janvier 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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