PMID- 24632340
OWN - NLM
STAT- MEDLINE
DCOM- 20150126
LR  - 20220409
IS  - 1532-8414 (Electronic)
IS  - 1071-9164 (Linking)
VI  - 20
IP  - 6
DP  - 2014 Jun
TI  - Predictors and outcomes of "super-response" to cardiac resynchronization therapy.
PG  - 379-86
LID - S1071-9164(14)00094-3 [pii]
LID - 10.1016/j.cardfail.2014.03.001 [doi]
AB  - BACKGROUND: Cardiac resynchronization therapy (CRT) has been shown to improve 
      heart failure (HF) symptoms and survival. We hypothesized that a greater 
      improvement in left-ventricular ejection fraction (LVEF) after CRT is associated 
      with greater survival benefit. METHODS AND RESULTS: In 693 patients across 2 
      international centers, the improvement in LVEF after CRT was determined. Patients 
      were grouped as non-/modest-, moderate-, or super-responders to CRT, defined as 
      an absolute change in LVEF of </=5%, 6-15%, and >15%, respectively. Changes in New 
      York Heart Association (NYHA) functional class and left ventricular end-diastolic 
      dimension (LVEDD) were assessed for each group. There were 395 non-/modest-, 186 
      moderate-, and 112 super-responders. Super-responders were more likely to be 
      female and to have nonischemic cardiomyopathy, lower creatinine, and lower 
      pulmonary artery systolic pressure than non-/modest- and moderate-responders. 
      Super-responders were also more likely to have lower LVEF than 
      non-/modest-responders. There was no difference in NYHA functional class, mitral 
      regurgitation grade, or tricuspid regurgitation grade between groups. Improvement 
      in NYHA functional class (-0.9 +/- 0.9 vs -0.4 +/- 0.8 [P < .001] and -0.6 +/- 0.8 
      [P = .02]) and LVEDD (-8.7 +/- 9.9 mm vs -0.5 +/- 5.0 and -2.4 +/- 5.8 mm [P < .001 for 
      both]) was greatest in super-responders. Kaplan-Meier survival analysis revealed 
      that super-responders achieved better survival compared with non-/modest- 
      (P < .001) and moderate-responders (P = .049). CONCLUSIONS: Improvement in HF 
      symptoms and survival after CRT is proportionate to the degree of improvement in 
      LV systolic function. Super-response is more likely in women, those with 
      nonischemic substrate, and those with lower pulmonary artery systolic pressure.
CI  - Copyright (c) 2014 Elsevier Inc. All rights reserved.
FAU - Killu, Ammar M
AU  - Killu AM
AD  - Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
FAU - Grupper, Avishay
AU  - Grupper A
AD  - Davidai Arrhythmia Center, Leviev Heart Center, Sheba Medical Center, Tel 
      Hashomer, Israel.
FAU - Friedman, Paul A
AU  - Friedman PA
AD  - Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
FAU - Powell, Brian D
AU  - Powell BD
AD  - Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
FAU - Asirvatham, Samuel J
AU  - Asirvatham SJ
AD  - Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
FAU - Espinosa, Raul E
AU  - Espinosa RE
AD  - Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
FAU - Luria, David
AU  - Luria D
AD  - Davidai Arrhythmia Center, Leviev Heart Center, Sheba Medical Center, Tel 
      Hashomer, Israel.
FAU - Rozen, Guy
AU  - Rozen G
AD  - Davidai Arrhythmia Center, Leviev Heart Center, Sheba Medical Center, Tel 
      Hashomer, Israel.
FAU - Buber, Jonathan
AU  - Buber J
AD  - Davidai Arrhythmia Center, Leviev Heart Center, Sheba Medical Center, Tel 
      Hashomer, Israel.
FAU - Lee, Ying-Hsiang
AU  - Lee YH
AD  - Cardiovascular Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
FAU - Webster, Tracy
AU  - Webster T
AD  - Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
FAU - Brooke, Kelly L
AU  - Brooke KL
AD  - Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
FAU - Hodge, David O
AU  - Hodge DO
AD  - Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, 
      Minnesota.
FAU - Wiste, Heather J
AU  - Wiste HJ
AD  - Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, 
      Minnesota.
FAU - Glikson, Michael
AU  - Glikson M
AD  - Davidai Arrhythmia Center, Leviev Heart Center, Sheba Medical Center, Tel 
      Hashomer, Israel.
FAU - Cha, Yong-Mei
AU  - Cha YM
AD  - Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota. 
      Electronic address: ycha@mayo.edu.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20140312
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
SB  - IM
MH  - Aged
MH  - Cardiac Resynchronization Therapy/mortality/*trends
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*diagnosis/mortality/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Stroke Volume/*physiology
MH  - Survival Rate/trends
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Cardiac resynchronization
OT  - ICD
OT  - heart failure
OT  - pacemaker
OT  - treatment
EDAT- 2014/03/19 06:00
MHDA- 2015/01/27 06:00
CRDT- 2014/03/18 06:00
PHST- 2013/05/27 00:00 [received]
PHST- 2014/01/28 00:00 [revised]
PHST- 2014/03/04 00:00 [accepted]
PHST- 2014/03/18 06:00 [entrez]
PHST- 2014/03/19 06:00 [pubmed]
PHST- 2015/01/27 06:00 [medline]
AID - S1071-9164(14)00094-3 [pii]
AID - 10.1016/j.cardfail.2014.03.001 [doi]
PST - ppublish
SO  - J Card Fail. 2014 Jun;20(6):379-86. doi: 10.1016/j.cardfail.2014.03.001. Epub 
      2014 Mar 12.