Electro-echocardiographic Indices to Predict Cardiac Resynchronization Therapy Non-response on Non-ischemic Cardiomyopathy

Abstract

Cardiac resynchronization therapy (CRT) threw lights on heart failure treatment, however, parts of patients showed nonresponse to CRT. Unfortunately, it lacks effective parameters to predict CRT non-response. In present study, we try to seek effective electro-echocardiographic predictors on CRT non-response. This is a retrospective study to review a total of 227 patients of dyssynchronous heart failure underwent CRT implantation. Logistic analysis was performed between CRT responders and CRT non-responders. The primary outcome was the occurrence of improved left ventricular ejection fraction 1 year after CRT implantation. We concluded that LVEDV > 255 mL ( OR =  2.236; 95% CI, 1.016– 4.923) rather than LVESV > 160 mL ( OR =  1.18; 95% CI, 0.544– 2.56) and TpTe/QTc > 0.203 ( OR =  5.206; 95% CI, 1.89– 14.34) significantly predicted CRT non-response. Oppositely, S wave > 5.7 cm/s ( OR =  0.242; 95% CI, 0.089– 0.657), E/A > 1 ( OR =  0.211; 95% CI, 0.079– 0.566), E’/A’ > 1 ( OR =  0.054; 95% CI, 0.017– 0.172), CLBBB ( OR =  0.141; 95% CI, 0.048– 0.409), and QRS duration >160 ms ( OR =  0.52; 95% CI, 0.305– 0.922) surprisingly predicted low-probability of CRT non-response.