Impact of S-Wave Amplitude in Right Precordial Leads on Improvement in Mitral Regurgitation following Cardiac Resynchronization Therapy
Background: The therapeutic strategy for mitral regurgitation (MR) in patients with advanced heart failure and wide QRS complex who are indicated for both intervention to MR and cardiac resynchronization therapy (CRT), remains unclear. Objective: We aimed to determine electrocardiogram parameters th...
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| Format: | Article |
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MDPI AG
2022-05-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/9/5/159 |
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| author | Naoya Kataoka Teruhiko Imamura Takahisa Koi Shuhei Tanaka Nobuyuki Fukuda Hiroshi Ueno Koichiro Kinugawa |
| author_facet | Naoya Kataoka Teruhiko Imamura Takahisa Koi Shuhei Tanaka Nobuyuki Fukuda Hiroshi Ueno Koichiro Kinugawa |
| author_sort | Naoya Kataoka |
| collection | DOAJ |
| description | Background: The therapeutic strategy for mitral regurgitation (MR) in patients with advanced heart failure and wide QRS complex who are indicated for both intervention to MR and cardiac resynchronization therapy (CRT), remains unclear. Objective: We aimed to determine electrocardiogram parameters that associate with MR reduction following CRT implantation. Methods: Among the patients with advanced heart failure and functional MR who intended to receive CRT implantation, baseline QRS morphology, electrical axis, PR interval, QRS duration, and averaged S-wave in right precordial leads (V1 to V3) in surface electrocardiogram were measured. The impact of these parameters on MR reduction following CRT implantation, which was defined as a reduction in MR ≥1 grade six months later, was investigated. Results: In 35 patients (median 71 years old, 18 men), 17 (49%) achieved an MR reduction following CRT implantation. Among baseline characteristics, only the higher S-wave amplitude in right precordial leads was an independent predictor of MR reduction (odds ratio 14.00, 95% confidence interval 1.65–119.00, <i>p</i> = 0.016) with a cutoff of 1.3 mV calculated through the area under the curve. The cutoff significantly stratified the cumulative incidences of heart failure re-admission and percutaneous mitral valve repair following CRT implantation (<i>p</i> = 0.032 and <i>p</i> = 0.011, respectively). Conclusions: In patients with advanced heart failure and functional MR, the baseline higher amplitude of S-wave in the right precordial leads might be a good indicator of MR improvement following CRT. |
| first_indexed | 2024-03-10T03:40:37Z |
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| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-10T03:40:37Z |
| publishDate | 2022-05-01 |
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| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-8ee1f4962cfe4aa981a26f866fb180982023-11-23T11:32:59ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252022-05-019515910.3390/jcdd9050159Impact of S-Wave Amplitude in Right Precordial Leads on Improvement in Mitral Regurgitation following Cardiac Resynchronization TherapyNaoya Kataoka0Teruhiko Imamura1Takahisa Koi2Shuhei Tanaka3Nobuyuki Fukuda4Hiroshi Ueno5Koichiro Kinugawa6Second Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, JapanSecond Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, JapanSecond Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, JapanSecond Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, JapanSecond Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, JapanSecond Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, JapanSecond Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, JapanBackground: The therapeutic strategy for mitral regurgitation (MR) in patients with advanced heart failure and wide QRS complex who are indicated for both intervention to MR and cardiac resynchronization therapy (CRT), remains unclear. Objective: We aimed to determine electrocardiogram parameters that associate with MR reduction following CRT implantation. Methods: Among the patients with advanced heart failure and functional MR who intended to receive CRT implantation, baseline QRS morphology, electrical axis, PR interval, QRS duration, and averaged S-wave in right precordial leads (V1 to V3) in surface electrocardiogram were measured. The impact of these parameters on MR reduction following CRT implantation, which was defined as a reduction in MR ≥1 grade six months later, was investigated. Results: In 35 patients (median 71 years old, 18 men), 17 (49%) achieved an MR reduction following CRT implantation. Among baseline characteristics, only the higher S-wave amplitude in right precordial leads was an independent predictor of MR reduction (odds ratio 14.00, 95% confidence interval 1.65–119.00, <i>p</i> = 0.016) with a cutoff of 1.3 mV calculated through the area under the curve. The cutoff significantly stratified the cumulative incidences of heart failure re-admission and percutaneous mitral valve repair following CRT implantation (<i>p</i> = 0.032 and <i>p</i> = 0.011, respectively). Conclusions: In patients with advanced heart failure and functional MR, the baseline higher amplitude of S-wave in the right precordial leads might be a good indicator of MR improvement following CRT.https://www.mdpi.com/2308-3425/9/5/159heart failurecardiac resynchronization therapyQRS amplitude |
| spellingShingle | Naoya Kataoka Teruhiko Imamura Takahisa Koi Shuhei Tanaka Nobuyuki Fukuda Hiroshi Ueno Koichiro Kinugawa Impact of S-Wave Amplitude in Right Precordial Leads on Improvement in Mitral Regurgitation following Cardiac Resynchronization Therapy Journal of Cardiovascular Development and Disease heart failure cardiac resynchronization therapy QRS amplitude |
| title | Impact of S-Wave Amplitude in Right Precordial Leads on Improvement in Mitral Regurgitation following Cardiac Resynchronization Therapy |
| title_full | Impact of S-Wave Amplitude in Right Precordial Leads on Improvement in Mitral Regurgitation following Cardiac Resynchronization Therapy |
| title_fullStr | Impact of S-Wave Amplitude in Right Precordial Leads on Improvement in Mitral Regurgitation following Cardiac Resynchronization Therapy |
| title_full_unstemmed | Impact of S-Wave Amplitude in Right Precordial Leads on Improvement in Mitral Regurgitation following Cardiac Resynchronization Therapy |
| title_short | Impact of S-Wave Amplitude in Right Precordial Leads on Improvement in Mitral Regurgitation following Cardiac Resynchronization Therapy |
| title_sort | impact of s wave amplitude in right precordial leads on improvement in mitral regurgitation following cardiac resynchronization therapy |
| topic | heart failure cardiac resynchronization therapy QRS amplitude |
| url | https://www.mdpi.com/2308-3425/9/5/159 |
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