Echocardiographic measures of acute haemodynamic response after cardiac resynchronization therapy predict long-term clinical outcome

Francois B. Tournoux, Chrisfouad Raif Alabiad, Dali Fan, Annabel A. Chen, Miguel Chaput, Edwin Kevin Heist, Theofanie Mela, Moussa Mansour, Vivek Reddy, Jeremy N. Ruskin, Michael H. Picard, Jagmeet P. Singh

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Aims: Although acute haemodynamic improvement in response to cardiac resynchronization therapy (CRT) is reflective of a favourable cardiac contractile response, there is limited information regarding not only its ability to predict long-term clinical outcome but also cardiac-substrate- specific differences in the prognostic value of this measure. Methods and results: Fifty-three heart failure patients (69 ± 11 years) with low left ventricle ejection fraction (LVEF) (22 ± 6%), wide QRS (169 ± 31 ms), and indications for CRT were included. There were no significant differences in age, New York Heart Association (NYHA) class, medications, QRS width, or LVEF between ischaemic (n = 37) and non-ischaemic (n = 16) groups. Echocardiograms were performed within 24 h of implantation with device OFF and ON. Acute haemodynamic response was measured as LV dP/dt derived from the CW Doppler of mitral regurgitation. Percentage change in dP/dt was used to classify patients: high- (HR: ΔdP/dt > 25%) or poor-responders (PR: ΔdP/dt ≤ 25%). Clinical response to CRT was defined by a combined endpoint of hospitalizations and all-cause mortality at 12 months. HR group had a significantly better outcome compared to the PR group (P-value = 0.004) irrespective of the aetiology of the cardiomyopathy. Conclusion: Echocardiographic assessment of the acute haemodynamic response to CRT predicts long-term clinical outcome in both ischaemic and non-ischaemic cardiomyopathy.

Original languageEnglish
Pages (from-to)1143-1148
Number of pages6
JournalEuropean Heart Journal
Volume28
Issue number9
DOIs
StatePublished - May 1 2007
Externally publishedYes

Fingerprint

Cardiac Resynchronization Therapy
Hemodynamics
Cardiomyopathies
Heart Ventricles
Mitral Valve Insufficiency
Hospitalization
Heart Failure
Equipment and Supplies
Mortality

Keywords

  • Cardiomyopathy
  • Doppler
  • dP/dt
  • Heart failure
  • Long-term outcome
  • Resynchronization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Echocardiographic measures of acute haemodynamic response after cardiac resynchronization therapy predict long-term clinical outcome. / Tournoux, Francois B.; Alabiad, Chrisfouad Raif; Fan, Dali; Chen, Annabel A.; Chaput, Miguel; Heist, Edwin Kevin; Mela, Theofanie; Mansour, Moussa; Reddy, Vivek; Ruskin, Jeremy N.; Picard, Michael H.; Singh, Jagmeet P.

In: European Heart Journal, Vol. 28, No. 9, 01.05.2007, p. 1143-1148.

Research output: Contribution to journalArticle

Tournoux, FB, Alabiad, CR, Fan, D, Chen, AA, Chaput, M, Heist, EK, Mela, T, Mansour, M, Reddy, V, Ruskin, JN, Picard, MH & Singh, JP 2007, 'Echocardiographic measures of acute haemodynamic response after cardiac resynchronization therapy predict long-term clinical outcome', European Heart Journal, vol. 28, no. 9, pp. 1143-1148. https://doi.org/10.1093/eurheartj/ehm050
Tournoux, Francois B. ; Alabiad, Chrisfouad Raif ; Fan, Dali ; Chen, Annabel A. ; Chaput, Miguel ; Heist, Edwin Kevin ; Mela, Theofanie ; Mansour, Moussa ; Reddy, Vivek ; Ruskin, Jeremy N. ; Picard, Michael H. ; Singh, Jagmeet P. / Echocardiographic measures of acute haemodynamic response after cardiac resynchronization therapy predict long-term clinical outcome. In: European Heart Journal. 2007 ; Vol. 28, No. 9. pp. 1143-1148.
@article{0e9099dfb03a48ff9a97c6cf90fbef56,
title = "Echocardiographic measures of acute haemodynamic response after cardiac resynchronization therapy predict long-term clinical outcome",
abstract = "Aims: Although acute haemodynamic improvement in response to cardiac resynchronization therapy (CRT) is reflective of a favourable cardiac contractile response, there is limited information regarding not only its ability to predict long-term clinical outcome but also cardiac-substrate- specific differences in the prognostic value of this measure. Methods and results: Fifty-three heart failure patients (69 ± 11 years) with low left ventricle ejection fraction (LVEF) (22 ± 6{\%}), wide QRS (169 ± 31 ms), and indications for CRT were included. There were no significant differences in age, New York Heart Association (NYHA) class, medications, QRS width, or LVEF between ischaemic (n = 37) and non-ischaemic (n = 16) groups. Echocardiograms were performed within 24 h of implantation with device OFF and ON. Acute haemodynamic response was measured as LV dP/dt derived from the CW Doppler of mitral regurgitation. Percentage change in dP/dt was used to classify patients: high- (HR: ΔdP/dt > 25{\%}) or poor-responders (PR: ΔdP/dt ≤ 25{\%}). Clinical response to CRT was defined by a combined endpoint of hospitalizations and all-cause mortality at 12 months. HR group had a significantly better outcome compared to the PR group (P-value = 0.004) irrespective of the aetiology of the cardiomyopathy. Conclusion: Echocardiographic assessment of the acute haemodynamic response to CRT predicts long-term clinical outcome in both ischaemic and non-ischaemic cardiomyopathy.",
keywords = "Cardiomyopathy, Doppler, dP/dt, Heart failure, Long-term outcome, Resynchronization",
author = "Tournoux, {Francois B.} and Alabiad, {Chrisfouad Raif} and Dali Fan and Chen, {Annabel A.} and Miguel Chaput and Heist, {Edwin Kevin} and Theofanie Mela and Moussa Mansour and Vivek Reddy and Ruskin, {Jeremy N.} and Picard, {Michael H.} and Singh, {Jagmeet P.}",
year = "2007",
month = "5",
day = "1",
doi = "10.1093/eurheartj/ehm050",
language = "English",
volume = "28",
pages = "1143--1148",
journal = "European Heart Journal",
issn = "0195-668X",
publisher = "Oxford University Press",
number = "9",

}

TY - JOUR

T1 - Echocardiographic measures of acute haemodynamic response after cardiac resynchronization therapy predict long-term clinical outcome

AU - Tournoux, Francois B.

AU - Alabiad, Chrisfouad Raif

AU - Fan, Dali

AU - Chen, Annabel A.

AU - Chaput, Miguel

AU - Heist, Edwin Kevin

AU - Mela, Theofanie

AU - Mansour, Moussa

AU - Reddy, Vivek

AU - Ruskin, Jeremy N.

AU - Picard, Michael H.

AU - Singh, Jagmeet P.

PY - 2007/5/1

Y1 - 2007/5/1

N2 - Aims: Although acute haemodynamic improvement in response to cardiac resynchronization therapy (CRT) is reflective of a favourable cardiac contractile response, there is limited information regarding not only its ability to predict long-term clinical outcome but also cardiac-substrate- specific differences in the prognostic value of this measure. Methods and results: Fifty-three heart failure patients (69 ± 11 years) with low left ventricle ejection fraction (LVEF) (22 ± 6%), wide QRS (169 ± 31 ms), and indications for CRT were included. There were no significant differences in age, New York Heart Association (NYHA) class, medications, QRS width, or LVEF between ischaemic (n = 37) and non-ischaemic (n = 16) groups. Echocardiograms were performed within 24 h of implantation with device OFF and ON. Acute haemodynamic response was measured as LV dP/dt derived from the CW Doppler of mitral regurgitation. Percentage change in dP/dt was used to classify patients: high- (HR: ΔdP/dt > 25%) or poor-responders (PR: ΔdP/dt ≤ 25%). Clinical response to CRT was defined by a combined endpoint of hospitalizations and all-cause mortality at 12 months. HR group had a significantly better outcome compared to the PR group (P-value = 0.004) irrespective of the aetiology of the cardiomyopathy. Conclusion: Echocardiographic assessment of the acute haemodynamic response to CRT predicts long-term clinical outcome in both ischaemic and non-ischaemic cardiomyopathy.

AB - Aims: Although acute haemodynamic improvement in response to cardiac resynchronization therapy (CRT) is reflective of a favourable cardiac contractile response, there is limited information regarding not only its ability to predict long-term clinical outcome but also cardiac-substrate- specific differences in the prognostic value of this measure. Methods and results: Fifty-three heart failure patients (69 ± 11 years) with low left ventricle ejection fraction (LVEF) (22 ± 6%), wide QRS (169 ± 31 ms), and indications for CRT were included. There were no significant differences in age, New York Heart Association (NYHA) class, medications, QRS width, or LVEF between ischaemic (n = 37) and non-ischaemic (n = 16) groups. Echocardiograms were performed within 24 h of implantation with device OFF and ON. Acute haemodynamic response was measured as LV dP/dt derived from the CW Doppler of mitral regurgitation. Percentage change in dP/dt was used to classify patients: high- (HR: ΔdP/dt > 25%) or poor-responders (PR: ΔdP/dt ≤ 25%). Clinical response to CRT was defined by a combined endpoint of hospitalizations and all-cause mortality at 12 months. HR group had a significantly better outcome compared to the PR group (P-value = 0.004) irrespective of the aetiology of the cardiomyopathy. Conclusion: Echocardiographic assessment of the acute haemodynamic response to CRT predicts long-term clinical outcome in both ischaemic and non-ischaemic cardiomyopathy.

KW - Cardiomyopathy

KW - Doppler

KW - dP/dt

KW - Heart failure

KW - Long-term outcome

KW - Resynchronization

UR - http://www.scopus.com/inward/record.url?scp=34547779970&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34547779970&partnerID=8YFLogxK

U2 - 10.1093/eurheartj/ehm050

DO - 10.1093/eurheartj/ehm050

M3 - Article

C2 - 17449877

AN - SCOPUS:34547779970

VL - 28

SP - 1143

EP - 1148

JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

IS - 9

ER -