Volumetric Response beyond Six Months of Cardiac Resynchronization Therapy and Clinical Outcome.
Response to cardiac resynchronization therapy (CRT) is often assessed six months after implantation. Our objective was to assess the number of patients changing from responder to non-responder between six and 14 months, so-called late non-responders, and compare them to patients who were responder b...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2015-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4416763?pdf=render |
| _version_ | 1818152119975280640 |
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| author | Jetske van 't Sant Aernoud T L Fiolet Iris A H ter Horst Maarten J Cramer Mirjam H Mastenbroek Wouter M van Everdingen Thomas P Mast Pieter A Doevendans Henneke Versteeg Mathias Meine |
| author_facet | Jetske van 't Sant Aernoud T L Fiolet Iris A H ter Horst Maarten J Cramer Mirjam H Mastenbroek Wouter M van Everdingen Thomas P Mast Pieter A Doevendans Henneke Versteeg Mathias Meine |
| author_sort | Jetske van 't Sant |
| collection | DOAJ |
| description | Response to cardiac resynchronization therapy (CRT) is often assessed six months after implantation. Our objective was to assess the number of patients changing from responder to non-responder between six and 14 months, so-called late non-responders, and compare them to patients who were responder both at six and 14 months, so-called stable responders. Furthermore, we assessed predictive values of six and 14-month response concerning clinical outcome.105 patients eligible for CRT were enrolled. Clinical, laboratory, ECG, and echocardiographic parameters and patient-reported health status (Kansas City Cardiomyopathy Questionnaire [KCCQ]) were assessed before, and six and 14 months after implantation. Response was defined as ≥15% LVESV decrease as compared to baseline. Major adverse cardiac events (MACE) were registered until 24 months after implantation. Predictive values of six and 14-month response for MACE were examined.In total, 75 (71%) patients were six-month responders of which 12 (16%) patients became late non-responder. At baseline, late non-responders more often had ischemic cardiomyopathy and atrial fibrillation, higher BNP and less dyssynchrony compared to stable responders. At six months, late non-responders showed significantly less LVESV decrease, and higher creatinine levels. Mean KCCQ scores of late non-responders were lower than those of stable responders at every time point, with the difference being significant at 14 months. The 14 months response was a better predictor of MACE than six months response.The assessment of treatment outcomes after six months of CRT could be premature and response rates beyond might better correlate to long-term clinical outcome. |
| first_indexed | 2024-12-11T13:49:40Z |
| format | Article |
| id | doaj.art-f0b245c982e3422081c53d4c1aed1933 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-11T13:49:40Z |
| publishDate | 2015-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-f0b245c982e3422081c53d4c1aed19332022-12-22T01:04:21ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01105e012432310.1371/journal.pone.0124323Volumetric Response beyond Six Months of Cardiac Resynchronization Therapy and Clinical Outcome.Jetske van 't SantAernoud T L FioletIris A H ter HorstMaarten J CramerMirjam H MastenbroekWouter M van EverdingenThomas P MastPieter A DoevendansHenneke VersteegMathias MeineResponse to cardiac resynchronization therapy (CRT) is often assessed six months after implantation. Our objective was to assess the number of patients changing from responder to non-responder between six and 14 months, so-called late non-responders, and compare them to patients who were responder both at six and 14 months, so-called stable responders. Furthermore, we assessed predictive values of six and 14-month response concerning clinical outcome.105 patients eligible for CRT were enrolled. Clinical, laboratory, ECG, and echocardiographic parameters and patient-reported health status (Kansas City Cardiomyopathy Questionnaire [KCCQ]) were assessed before, and six and 14 months after implantation. Response was defined as ≥15% LVESV decrease as compared to baseline. Major adverse cardiac events (MACE) were registered until 24 months after implantation. Predictive values of six and 14-month response for MACE were examined.In total, 75 (71%) patients were six-month responders of which 12 (16%) patients became late non-responder. At baseline, late non-responders more often had ischemic cardiomyopathy and atrial fibrillation, higher BNP and less dyssynchrony compared to stable responders. At six months, late non-responders showed significantly less LVESV decrease, and higher creatinine levels. Mean KCCQ scores of late non-responders were lower than those of stable responders at every time point, with the difference being significant at 14 months. The 14 months response was a better predictor of MACE than six months response.The assessment of treatment outcomes after six months of CRT could be premature and response rates beyond might better correlate to long-term clinical outcome.http://europepmc.org/articles/PMC4416763?pdf=render |
| spellingShingle | Jetske van 't Sant Aernoud T L Fiolet Iris A H ter Horst Maarten J Cramer Mirjam H Mastenbroek Wouter M van Everdingen Thomas P Mast Pieter A Doevendans Henneke Versteeg Mathias Meine Volumetric Response beyond Six Months of Cardiac Resynchronization Therapy and Clinical Outcome. PLoS ONE |
| title | Volumetric Response beyond Six Months of Cardiac Resynchronization Therapy and Clinical Outcome. |
| title_full | Volumetric Response beyond Six Months of Cardiac Resynchronization Therapy and Clinical Outcome. |
| title_fullStr | Volumetric Response beyond Six Months of Cardiac Resynchronization Therapy and Clinical Outcome. |
| title_full_unstemmed | Volumetric Response beyond Six Months of Cardiac Resynchronization Therapy and Clinical Outcome. |
| title_short | Volumetric Response beyond Six Months of Cardiac Resynchronization Therapy and Clinical Outcome. |
| title_sort | volumetric response beyond six months of cardiac resynchronization therapy and clinical outcome |
| url | http://europepmc.org/articles/PMC4416763?pdf=render |
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