A Simple Predictive Marker in Cardiac Resynchronization Therapy Recipients: Prominent S-Wave in Right Precordial Leads
<i>Background and objectives:</i> Current guidelines criteria do not satisfactorily discriminate responders to cardiac resynchronization therapy (CRT). QRS amplitude is an established index to recognize the severity of myocardial disturbance and might be a key to optimal patient selectio...
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| Format: | Article |
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MDPI AG
2021-08-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/57/8/815 |
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| author | Naoya Kataoka Teruhiko Imamura Takahisa Koi Keisuke Uchida Koichiro Kinugawa |
| author_facet | Naoya Kataoka Teruhiko Imamura Takahisa Koi Keisuke Uchida Koichiro Kinugawa |
| author_sort | Naoya Kataoka |
| collection | DOAJ |
| description | <i>Background and objectives:</i> Current guidelines criteria do not satisfactorily discriminate responders to cardiac resynchronization therapy (CRT). QRS amplitude is an established index to recognize the severity of myocardial disturbance and might be a key to optimal patient selection for CRT. <i>Materials and Methods:</i> (1) Initial R-wave amplitude, (2) S-wave amplitude, and (3) a summation of maximal R- or R′-wave amplitude and S-wave amplitude were measured at baseline. These parameters were averaged according to right (V1 to V3) or left (V4 to V6) precordial leads. The impact of these parameters on response to CRT, which was defined as a decrease in left ventricular end-systolic volume ≥15% at six-month follow-up, was investigated. <i>Results:</i> Among 47 patients (71 years old, 28 men) who received guideline-indicated CRT implantation, 25 (53%) achieved the definition of CRT responder. Among baseline electrocardiogram parameters, only the higher S-wave amplitude in right precordial leads was an independent predictor of CRT responders (odds ratio: 2.181, 95% confidence interval: 1.078–4.414, <i>p</i> = 0.030) at a cutoff of 1.44 mV. The cutoff was independently associated with cumulative incidence of heart failure readmission and appropriate electrical defibrillation following CRT implantation (<i>p</i> < 0.05, respectively). <i>Conclusions:</i> Prominent S-wave in right precordial leads might be a promising index to predict left ventricular reverse remodeling and greater clinical outcomes following CRT implantation. |
| first_indexed | 2024-03-10T08:36:51Z |
| format | Article |
| id | doaj.art-3427615a441c48a7998d8c62c1d033d5 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T08:36:51Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-3427615a441c48a7998d8c62c1d033d52023-11-22T08:36:31ZengMDPI AGMedicina1010-660X1648-91442021-08-0157881510.3390/medicina57080815A Simple Predictive Marker in Cardiac Resynchronization Therapy Recipients: Prominent S-Wave in Right Precordial LeadsNaoya Kataoka0Teruhiko Imamura1Takahisa Koi2Keisuke Uchida3Koichiro Kinugawa4Department of Internal Medicine, University of Toyama, Sugitani, Toyama 930-0194, JapanDepartment of Internal Medicine, University of Toyama, Sugitani, Toyama 930-0194, JapanDepartment of Internal Medicine, University of Toyama, Sugitani, Toyama 930-0194, JapanDepartment of Internal Medicine, University of Toyama, Sugitani, Toyama 930-0194, JapanDepartment of Internal Medicine, University of Toyama, Sugitani, Toyama 930-0194, Japan<i>Background and objectives:</i> Current guidelines criteria do not satisfactorily discriminate responders to cardiac resynchronization therapy (CRT). QRS amplitude is an established index to recognize the severity of myocardial disturbance and might be a key to optimal patient selection for CRT. <i>Materials and Methods:</i> (1) Initial R-wave amplitude, (2) S-wave amplitude, and (3) a summation of maximal R- or R′-wave amplitude and S-wave amplitude were measured at baseline. These parameters were averaged according to right (V1 to V3) or left (V4 to V6) precordial leads. The impact of these parameters on response to CRT, which was defined as a decrease in left ventricular end-systolic volume ≥15% at six-month follow-up, was investigated. <i>Results:</i> Among 47 patients (71 years old, 28 men) who received guideline-indicated CRT implantation, 25 (53%) achieved the definition of CRT responder. Among baseline electrocardiogram parameters, only the higher S-wave amplitude in right precordial leads was an independent predictor of CRT responders (odds ratio: 2.181, 95% confidence interval: 1.078–4.414, <i>p</i> = 0.030) at a cutoff of 1.44 mV. The cutoff was independently associated with cumulative incidence of heart failure readmission and appropriate electrical defibrillation following CRT implantation (<i>p</i> < 0.05, respectively). <i>Conclusions:</i> Prominent S-wave in right precordial leads might be a promising index to predict left ventricular reverse remodeling and greater clinical outcomes following CRT implantation.https://www.mdpi.com/1648-9144/57/8/815heart failurecardiac resynchronization therapyQRS amplitude |
| spellingShingle | Naoya Kataoka Teruhiko Imamura Takahisa Koi Keisuke Uchida Koichiro Kinugawa A Simple Predictive Marker in Cardiac Resynchronization Therapy Recipients: Prominent S-Wave in Right Precordial Leads Medicina heart failure cardiac resynchronization therapy QRS amplitude |
| title | A Simple Predictive Marker in Cardiac Resynchronization Therapy Recipients: Prominent S-Wave in Right Precordial Leads |
| title_full | A Simple Predictive Marker in Cardiac Resynchronization Therapy Recipients: Prominent S-Wave in Right Precordial Leads |
| title_fullStr | A Simple Predictive Marker in Cardiac Resynchronization Therapy Recipients: Prominent S-Wave in Right Precordial Leads |
| title_full_unstemmed | A Simple Predictive Marker in Cardiac Resynchronization Therapy Recipients: Prominent S-Wave in Right Precordial Leads |
| title_short | A Simple Predictive Marker in Cardiac Resynchronization Therapy Recipients: Prominent S-Wave in Right Precordial Leads |
| title_sort | simple predictive marker in cardiac resynchronization therapy recipients prominent s wave in right precordial leads |
| topic | heart failure cardiac resynchronization therapy QRS amplitude |
| url | https://www.mdpi.com/1648-9144/57/8/815 |
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