PMID- 21314865
OWN - NLM
STAT- MEDLINE
DCOM- 20111222
LR  - 20110214
IS  - 1742-1241 (Electronic)
IS  - 1368-5031 (Linking)
VI  - 65
IP  - 3
DP  - 2011 Mar
TI  - Male gender and chronic obstructive pulmonary disease predict a poor clinical 
      response in patients undergoing cardiac resynchronisation therapy.
PG  - 281-8
LID - 10.1111/j.1742-1241.2010.02491.x [doi]
AB  - AIMS: Current guidelines advocate cardiac resynchronisation therapy (CRT) in 
      patients with class III/IV New York Heart Association (NYHA) heart failure, 
      depressed left ventricular function and a broad QRS. However, a significant 
      proportion of patients do not derive any benefit from CRT. The aim of this study 
      was to identify clinical, electrocardiographic and echocardiographic predictors 
      of response to CRT. METHODS: A retrospective analysis of patients undergoing CRT 
      in our institution was performed. A favourable clinical response to CRT was 
      defined as an improvement in NYHA Heart failure class of >/= 1 and lack of 
      hospitalisation with heart failure. Comparisons were made between responders and 
      non-responders in terms of baseline characteristics and potential predictors of 
      CRT response (QRS width, presence of left bundle branch block, atrial 
      fibrillation, evidence of mechanical dyssynchrony on echocardiography and LV lead 
      position). RESULTS: A total of 164 patients had full follow-up data. The mean 
      follow-up was 293 days. Of patients undergoing CRT, 90 (58.9%) had a favourable 
      clinical response to CRT. Predictors of a lack of clinical response to CRT were 
      male gender (p = 0.012) and chronic obstructive pulmonary disease (COPD) (0.008). 
      Pre-implant echocardiographic dyssynchrony assessment appeared not to predict 
      response to CRT (p = 0.87); however, there was a trend towards a positive 
      response in those patients with significant dyssynchrony (p = 0.09) defined as 
      interventricular delay > 40 ms or maximal LV delay of > 80 ms. CONCLUSION: Male 
      gender and coexisting COPD were shown to be independent predictors of 
      non-response to CRT in this cohort of patients fulfilling current criteria for 
      CRT.
CI  - (c) 2011 Blackwell Publishing Ltd.
FAU - Kirubakaran, S
AU  - Kirubakaran S
AD  - Cardiothoracic Centre, Guy's and St. Thomas' Hospital NHS Trust, London, UK. 
      senthilk1uk@yahoo.co.uk
FAU - Ladwiniec, A
AU  - Ladwiniec A
FAU - Arujuna, A
AU  - Arujuna A
FAU - Ginks, M
AU  - Ginks M
FAU - McPhail, M
AU  - McPhail M
FAU - Bostock, J
AU  - Bostock J
FAU - Carr-White, G
AU  - Carr-White G
FAU - Rinaldi, C A
AU  - Rinaldi CA
LA  - eng
PT  - Journal Article
PL  - India
TA  - Int J Clin Pract
JT  - International journal of clinical practice
JID - 9712381
SB  - IM
MH  - Aged
MH  - Atrial Fibrillation/complications/therapy
MH  - *Cardiac Resynchronization Therapy
MH  - Defibrillators, Implantable
MH  - Female
MH  - Heart Failure/complications/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pulmonary Disease, Chronic Obstructive/*complications
MH  - Retrospective Studies
MH  - Sex Factors
MH  - Treatment Outcome
EDAT- 2011/02/15 06:00
MHDA- 2011/12/23 06:00
CRDT- 2011/02/15 06:00
PHST- 2011/02/15 06:00 [entrez]
PHST- 2011/02/15 06:00 [pubmed]
PHST- 2011/12/23 06:00 [medline]
AID - 10.1111/j.1742-1241.2010.02491.x [doi]
PST - ppublish
SO  - Int J Clin Pract. 2011 Mar;65(3):281-8. doi: 10.1111/j.1742-1241.2010.02491.x.