PMID- 22555272
OWN - NLM
STAT- MEDLINE
DCOM- 20121009
LR  - 20161125
IS  - 1532-8414 (Electronic)
IS  - 1071-9164 (Linking)
VI  - 18
IP  - 5
DP  - 2012 May
TI  - Septal rebound stretch is a strong predictor of outcome after cardiac 
      resynchronization therapy.
PG  - 404-12
LID - 10.1016/j.cardfail.2012.02.001 [doi]
AB  - BACKGROUND: Septal rebound stretch (SRSsept) is a distinctive characteristic of 
      discoordination-related mechanical inefficiency. We assessed how intermediate- 
      and long-term outcome after cardiac resynchronization therapy (CRT) relate to 
      baseline SRSsept. METHODS AND RESULTS: A total of 101 patients (age 65 +/- 11 
      years, 69 men, 18 New York Heart Association (NYHA) class IV, QRS 173 +/- 23 ms) 
      scheduled for CRT underwent clinical assessment, echocardiography, and brain-type 
      natriuretic peptide (BNP) measurements before and 6.4 +/- 2.3 months after CRT. 
      Baseline SRSsept (all systolic stretch after initial shortening in the septum) 
      was quantified by speckle tracking echocardiography. Primary composite end point 
      was death, urgent cardiac transplantation, or left ventricular assist device 
      implantation at the end of the study. Secondary end points were intermediate-term 
      (6 months) response, quantified as decreases in left ventricular end-systolic 
      volume (DeltaLVESV) and BNP (DeltaBNP). After a mean clinical follow-up of 15.6 +/- 9.0 
      months; 23 patients had reached the primary end point. Baseline SRSsept (hazard 
      ratio [HR] 0.742; 95% confidence intervals [CI] 0.601-0.916, P < .01]) was 
      independently associated with a better outcome and NYHA class (HR 5.786: 95% CI 
      2.341-14.299, P < .001) with a worse outcome. Contrary to baseline NYHA class, 
      baseline SRSsept was an independent predictor of both DeltaLVESV (beta 0.53; P < 
      .001) and DeltaBNP (beta 0.29; P < .01). Intermediate-term DeltaLVESV and DeltaBNP were 
      associated with a favorable long-term outcome. CONCLUSIONS: SRSsept at baseline 
      is a strong, independent predictor of long-term prognosis after CRT and of 
      improvements in left ventricular remodeling and neurohormonal activation at 
      intermediate term.
CI  - Copyright (c) 2012 Elsevier Inc. All rights reserved.
FAU - Leenders, Geert E
AU  - Leenders GE
AD  - Department of Cardiology, University Medical Center Utrecht, Utrecht, The 
      Netherlands. g.e.h.leenders@umcutrecht.nl
FAU - De Boeck, Bart W L
AU  - De Boeck BW
FAU - Teske, Arco J
AU  - Teske AJ
FAU - Meine, Mathias
AU  - Meine M
FAU - Bogaard, Margot D
AU  - Bogaard MD
FAU - Prinzen, Frits W
AU  - Prinzen FW
FAU - Doevendans, Pieter A
AU  - Doevendans PA
FAU - Cramer, Maarten J
AU  - Cramer MJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20120310
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
SB  - IM
MH  - Aged
MH  - *Cardiac Resynchronization Therapy
MH  - Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/diagnostic imaging/physiopathology/*therapy
MH  - Heart Septum/diagnostic imaging/*physiopathology
MH  - Humans
MH  - Male
MH  - Prognosis
MH  - Retrospective Studies
MH  - Ventricular Remodeling/*physiology
EDAT- 2012/05/05 06:00
MHDA- 2012/10/10 06:00
CRDT- 2012/05/05 06:00
PHST- 2011/05/18 00:00 [received]
PHST- 2012/01/31 00:00 [revised]
PHST- 2012/02/01 00:00 [accepted]
PHST- 2012/05/05 06:00 [entrez]
PHST- 2012/05/05 06:00 [pubmed]
PHST- 2012/10/10 06:00 [medline]
AID - S1071-9164(12)00051-6 [pii]
AID - 10.1016/j.cardfail.2012.02.001 [doi]
PST - ppublish
SO  - J Card Fail. 2012 May;18(5):404-12. doi: 10.1016/j.cardfail.2012.02.001. Epub 
      2012 Mar 10.