The Role of Echocardiography in Predicting Responders to Cardiac Resynchronization Therapy : Results From the Japan Cardiac Resynchronization Therapy Registry Trial (J-CRT)
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概要
- 論文の詳細を見る
Background: This multicenter prospective cohort study aimed to identify both ability of echocardiographic parameters to detect cardiac resynchronization therapy (CRT) volume responders and relation of these parameters with clinical outcomes. Methods and Results: CRT responder was defined as ≥15% reduction of left ventricular (LV) end-systolic volume at 6 months. Seven echocardiographic dyssynchrony parameters were evaluated. The clinical endpoint comprised time to death from any cause or unplanned hospitalization for a major cardiovascular event. Of the 217 patients enrolled, 63 percent were classified as volume responders, in whom significantly fewer events occurred than in non-responders (log rank, P<0.001). No single echocardiographic criterion had significant power to detect volume responders, but a combining measurement of dyssynchrony between septum and LV free wall with M-mode and tissue Doppler imaging was independently associated with volume responders. In addition, this combined parameter was associated with the endpoint (hazard ratio, 0.66, 95% confidence interval 0.30-0.98, P=0.04). In contrast, left bundle branch block was identified as an independent predictor of volume responders and more strongly associated with the endpoint (hazard ratio, 0.38, 95% confidence interval 0.20-0.72, P=0.003). Conclusions: Echocardiographic parameters did not show significant power to detect CRT responders independently. (Circ J 2011; 75: 1156-1163)
- 2011-04-25
著者
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Ando Kenji
Department of Cardiology, Kokura Memorial Hospital
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Naito Shigeto
Division Of Cardiology Gunma Prefectural Cardiovascular Center
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Aonuma Kazutaka
Cardiology Department Of Internal Medicine University Of Tsukuba Graduate School Of Comprehensive Hu
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Seo Yoshihiro
Cardiovascular Division Graduate School Of Comprehensive Human Sciences University Of Tsukuba
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Nakatani Satoshi
Department Of Cardiology National Cardiovascular Center
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TAKAMI Mitsuaki
Medtronic Japan Co Ltd
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Wakayama Yuji
Department Of Cardiovascular Medicine Tohoku University Graduate School Of Medicine
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Ando Kenji
Department Of Cardiology Kokura Memorial Hospital
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Takami Mitsuaki
Medtronic Japan Co. Ltd.
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Shiga Tsuyoshi
Department Of Cardiology The Heart Institute Of Japan Tokyo Women's Medical University
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Ando Kenji
Department Of Applied Chemistry Nagoya Institute Of Technology
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Ito Hiroshi
Department Of Cardiovascular And Respiratory Medicine Akita University Graduate School Of Medicine
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Wakayama Yuji
Department Of Cardiology Graduate School Of Medicine Tohoku University
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Aonuma Kazutaka
Cardiovascular Division Institute Of Clinical Medicine Graduate School Of Comprehensive Human Scienc
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Seo Yoshihiro
Cardiovascular Division Institute Of Clinical Medicine Graduate School Of Comprehensive Human Scienc
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Nakatani Satoshi
Department Of Functional Diagnostic Science Division Of Health Sciences Osaka University Graduate Sc
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Ito Hiroshi
Department Neurosurgery Tokyo Medical College
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Ito Hiroshi
Departments of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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