scholarly journals A Novel Risk Model for Mortality and Hospitalization following Cardiac Resynchronization Therapy in Patients with Non-ischemic Cardiomyopathy: The Alpha-score

2019 ◽  
Author(s):  
Shengwen Yang ◽  
Zhimin Liu ◽  
Yiran Hu ◽  
Ran Jing ◽  
Wei Hua
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Ischemic Cardiomyopathy ◽  
Risk Model ◽  
Heart Association ◽  
Cardiac Resynchronization ◽  
Reverse Remodeling ◽  
Resynchronization Therapy ◽  
Heart Failure Hospitalization ◽  
Class Iv

Abstract Background: Non-ischemic cardiomyopathy (NICM) has been associated with a better left ventricle reverse remodeling response and improved clinical outcomes after cardiac resynchronization therapy (CRT). The aims of our study were to identify the predictors of mortality and heart failure hospitalization in patients treated with CRT and design a risk score for prognosis. Methods: A cohort of 422 consecutive NICM patients with CRT was retrospectively enrolled between January 2010 and December 2017. The primary endpoint was all-cause mortality and heart transplantation. Results: In a multivariate analysis, the predictors of all-cause death were left atrial diameter [Hazard ratio (HR): 1.056, 95% confidence interval (CI): 1.020-1.093, P=0.002]; non-left bundle branch block [HR: 1.793, 95% CI: 1.131-2.844, P =0.013]; high sensitivity C-reactive protein [HR: 1.081, 95% CI: 1.029-1.134 P= 0.002]; and N-terminal pro-B-type natriuretic peptide [HR: 1.018, 95% CI: 1.007-1.030, P =0.002]; and New York Heart Association class IV [HR: 1.018, 95% CI: 1.007-1.030, P =0.002]. The Alpha-score ( A trial diameter, non- L BBB, P ro-BNP, H s-CRP, NYH A class IV) was derived from each independent risk factor. The novel score had good calibration (Hosmer-Lemeshow test, P >0.05) and discrimination for both primary endpoints [c-statistics: 0.749 (95% CI: 0.694-0.804), P <0.001] or heart failure hospitalization [c-statistics: 0.692 (95% CI: 0.639-0.745), P <0.001]. Conclusion: The Alpha-score may enable improved discrimination and accurate prediction of long-term outcomes among NICM patients with CRT.

scholarly journals A Novel Risk Model for Mortality and Hospitalization following Cardiac Resynchronization Therapy in Patients with Non-ischemic Cardiomyopathy: The Alpha-score

2020 ◽  
Author(s):  
Shengwen Yang ◽  
Zhimin Liu ◽  
Yiran Hu ◽  
Ran Jing ◽  
Wei Hua
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Ischemic Cardiomyopathy ◽  
Risk Model ◽  
Heart Association ◽  
Cardiac Resynchronization ◽  
Reverse Remodeling ◽  
Resynchronization Therapy ◽  
Heart Failure Hospitalization ◽  
Class Iv

Abstract Background: Non-ischemic cardiomyopathy (NICM) has been associated with a better left ventricle reverse remodeling response and improved clinical outcomes after cardiac resynchronization therapy (CRT). The aims of our study were to identify the predictors of mortality and heart failure hospitalization in patients treated with CRT and design a risk score for prognosis. Methods: A cohort of 422 consecutive NICM patients with CRT was retrospectively enrolled between January 2010 and December 2017. The primary endpoint was all-cause mortality and heart transplantation. Results: In a multivariate analysis, the predictors of all-cause death were left atrial diameter [Hazard ratio (HR): 1.056, 95% confidence interval (CI): 1.020-1.093, P=0.002]; non-left bundle branch block [HR: 1.793, 95% CI: 1.131-2.844, P =0.013]; high sensitivity C-reactive protein [HR: 1.081, 95% CI: 1.029-1.134 P= 0.002]; and N-terminal pro-B-type natriuretic peptide [HR: 1.018, 95% CI: 1.007-1.030, P =0.002]; and New York Heart Association class IV [HR: 1.018, 95% CI: 1.007-1.030, P =0.002]. The Alpha-score ( A trial diameter, non- L BBB, P ro-BNP, H s-CRP, NYH A class IV) was derived from each independent risk factor. The novel score had good calibration (Hosmer-Lemeshow test, P >0.05) and discrimination for both primary endpoints [c-statistics: 0.749 (95% CI: 0.694-0.804), P <0.001] or heart failure hospitalization [c-statistics: 0.692 (95% CI: 0.639-0.745), P <0.001]. Conclusion: The Alpha-score may enable improved discrimination and accurate prediction of long-term outcomes among NICM patients with CRT.

scholarly journals A Novel Risk Model for Mortality and Hospitalization following Cardiac Resynchronization Therapy in Patients with Non-ischemic Cardiomyopathy: The Alpha-score

2020 ◽  
Author(s):  
Shengwen Yang ◽  
Zhimin Liu ◽  
Yiran Hu ◽  
Ran Jing ◽  
Min Gu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Ischemic Cardiomyopathy ◽  
Risk Model ◽  
Heart Association ◽  
Cardiac Resynchronization ◽  
Reverse Remodeling ◽  
Resynchronization Therapy ◽  
Heart Failure Hospitalization ◽  
Class Iv

Abstract Background: Non-ischemic cardiomyopathy (NICM) has been associated with a better left ventricle reverse remodeling response and improved clinical outcomes after cardiac resynchronization therapy (CRT). The aims of our study were to identify the predictors of mortality and heart failure hospitalization in patients treated with CRT and design a risk score for prognosis. Methods: A cohort of 422 consecutive NICM patients with CRT was retrospectively enrolled between January 2010 and December 2017. The primary endpoint was all-cause mortality and heart transplantation. Results: In a multivariate analysis, the predictors of all-cause death were left atrial diameter [Hazard ratio (HR): 1.056, 95% confidence interval (CI): 1.020-1.093, P=0.002]; non-left bundle branch block [HR: 1.793, 95% CI: 1.131-2.844, P =0.013]; high sensitivity C-reactive protein [HR: 1.081, 95% CI: 1.029-1.134 P= 0.002]; and N-terminal pro-B-type natriuretic peptide [HR: 1.018, 95% CI: 1.007-1.030, P =0.002]; and New York Heart Association class IV [HR: 1.018, 95% CI: 1.007-1.030, P =0.002]. The Alpha-score ( A trial diameter, non- L BBB, P ro-BNP, H s-CRP, NYH A class IV) was derived from each independent risk factor. The novel score had good calibration (Hosmer-Lemeshow, P >0.05) and discrimination for both primary endpoints [c-statistics: 0.749 (95% CI: 0.694-0.804), P <0.001] or heart failure hospitalization [c-statistics: 0.692 (95% CI: 0.639-0.745), P <0.001]. Conclusion: The Alpha-score may enable improved discrimination and accurate prediction of long-term outcomes among NICM patients with CRT.

scholarly journals A Novel Risk Model of Mortality and Hospitalization of Cardiac Resynchronization Therapy in Patients with Non-ischemic Cardiomyopathy: the Alpha-score

2019 ◽  
Author(s):  
Shengwen Yang ◽  
Zhimin Liu ◽  
Yiran Hu ◽  
Ran Jing ◽  
Wei Hua
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Ischemic Cardiomyopathy ◽  
Risk Model ◽  
Nyha Class ◽  
High Sensitivity ◽  
Cardiac Resynchronization ◽  
Reverse Remodeling ◽  
Resynchronization Therapy ◽  
Heart Failure Hospitalization

Abstract Background Non-ischemic cardiomyopathy (NICM) has been associated with a better LV reverse remodeling response and better clinical outcomes after cardiac resynchronization therapy (CRT). The aims of our study were to identify the predictors of mortality and heart failure hospitalization in patients treated with CRT and design a risk score for prognosis. Methods A cohort of 422 consecutive NICM patients with CRT was retrospectively enrolled between January 2010 and December 2017. The primary endpoint was all-cause mortality and the secondary endpoint was heart failure hospitalization. Results In a multivariate analysis the predictors of all-cause death were left atrial diameter [Hazard ratio (HR): 1.056, 95% confidence interval (CI): 1.020-1.093, P=0.002], non-left bundle branch block (HR: 1.793, 95% CI: 1.131-2.844, P =0.013), high sensitivity C-reactive protein (HR: 1.081, 95% CI: 1.029-1.134 P= 0.002), and N-terminal pro-B-type natriuretic peptide per 100 pg/ml (HR: 1.018, 95% CI: 1.007-1.030, P =0.002), NYHA IV (HR: 1.018, 95% CI: 1.007-1.030, P =0.002). The Alpha-score (Atrial diameter, non-LBBB, ProBNP, Hs-CRP, NYHA class IV) was derived from each independent risk factor. The novel score had better calibration (Hosmer-Lemeshow test, P >0.05) and discrimination for both all cause-death and heart transplantation [c-statistics: 0.749 (95% CI: 0.694-0.804), P <0.001] or heart failure hospitalization [c-statistics: 0.692 (95% CI: 0.639-0.745), P <0.001]. Conclusion The Alpha-score may enable better discrimination and accurate prediction of long-term outcomes among NICM patients with CRT.

Effect of Cardiac Resynchronization Therapy in Patients With New York Heart Association Functional Class IV Heart Failure

2010 ◽  
Vol 106 (8) ◽  
pp. 1146-1151 ◽  
Author(s):  
Rutger J. van Bommel ◽  
Eva van Rijnsoever ◽  
C. Jan Willem Borleffs ◽  
Victoria Delgado ◽  
Nina Ajmone Marsan ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Cardiac Resynchronization Therapy ◽  
Heart Association ◽  
Functional Class ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
New York Heart Association ◽  
Class Iv

Abstract 259: The Role of Gender in Cardiac Resynchronization Therapy Response in Patients with Optimal Anatomical and Electrical Left Ventricular Lead Location.

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Abhishek Bose ◽  
Jagdesh Kandala ◽  
Jagmeet P Singh
Keyword(s):  
Heart Failure ◽  
Gender Differences ◽  
Cardiac Resynchronization Therapy ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Reverse Remodeling ◽  
Resynchronization Therapy ◽  
Heart Failure Hospitalization ◽  
Lead Location

Background: While optimal left ventricular (LV) lead location and the female sex are known to predict a favorable response to cardiac resynchronization therapy (CRT), the role of gender differences affecting CRT outcomes in patients with optimal LV lead location remains uncertain. Methods: We analyzed a prospective cohort of 180 CRT patients. Anatomical lead location was confirmed by coronary venograms and chest radiographs. LV lead electrical delay (LVLED) was measured from QRS onset on surface ECG to the first sensed signal of the LV lead, and standardized based on native QRS width. Echocardiographic response was evaluated at baseline and 6 months. Time to first heart failure hospitalization or death was assessed over 3 years. Results: 100 patients (Age 68.2 ± 12.3 years; Baseline LVEF 23.2 ± 6.8 %, NYHA 3.0 ± 0.3) with optimal LV lead location defined as ‘long’ LVLED (LVLED>50%) with non-apical and anterolateral, lateral or posterolateral lead position were selected from the original cohort. They were further divided into the female (n=26) and male (n=74) groups. Baseline clinical characteristics were similar between groups except for a higher incidence of ischemic cardiomyopathy in males (72.4% vs. 47.1%, p=0.01) and longer QRS duration in females (171.3 ± 29.9 vs. 153.6 ± 26.9, p=0.008). Baseline echocardiographic characteristics revealed a smaller LV internal dimension in systole (LVIDs) and diastole (LVIDd) in females (51.7 ± 10.2 vs. 57.1 ± 8.9, p=0.02; 58.5% ± 10.1 vs. 64.5 ± 8.3, p=0.007 respectively). Survival with respect to first heart failure hospitalization (Figure 1A) and a composite of mortality and heart failure (Figure 1B) were comparable. Echocardiographic response, defined as an increase in mean LVEF by 10% was significant in females (+11.6 ± 11.0 % vs. +5.3 ± 9.0 %, p=0.01). Conclusion: In CRT patients with optimal lead location, females have superior outcomes with respect to reverse remodeling but gender differences donot appear to predict clinical outcomes.

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