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Impact on Long-Term Cardiovascular Outcomes of Different Cardiac Resynchronization Therapy Response Criteria

2018Journal article Open access
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dc.contributor.authorRodrigues, I
dc.contributor.authorAbreu, A
dc.contributor.authorOliveira, MM
dc.contributor.authorSilva Cunha, P
dc.contributor.authorSanta Clara, H
dc.contributor.authorOsório, P
dc.contributor.authorLousinha, A
dc.contributor.authorValente, B
dc.contributor.authorPortugal, G
dc.contributor.authorRio, P
dc.contributor.authorMorais, L
dc.contributor.authorSantos, V
dc.contributor.authorMota Carmo, M
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2019-08-06T15:37:36Z
dc.date.available2019-08-06T15:37:36Z
dc.date.issued2018
dc.description.abstractINTRODUCTION: There is a lack of consensus on the definition of response to cardiac resynchronization therapy (CRT), and it is not clear which response criteria have most influence on cardiac event-free survival. OBJECTIVES: To assess the predictive value of various response criteria in patients undergoing CRT and the agreement between them. METHODS: We performed a secondary analysis of the BETTER-HF trial. Patient response was classified at six months after CRT according to eleven criteria used in previous trials. The predictive value of response criteria for survival free from mortality, cardiac transplantation and heart failure hospitalization was assessed by Cox regression analysis. Agreement between the different response criteria was assessed using Cohen's kappa (κ). RESULTS: A total of 115 patients were followed for a mean of 25 months. During follow-up, 15 deaths occurred (13%) and 29 patients had at least one adverse cardiac event (25%). Only five of the eleven response criteria were predictors of event-free survival. The most powerful isolated clinical and echocardiographic predictors were a reduction of ≥1 NYHA functional class (HR 0.39 for responders; 95% CI 0.18-0.83, p=0.014) and an increase of at least 15% in left ventricular ejection fraction (HR 0.43, 95% CI 0.20-0.90, p=0.024), respectively. Agreement between the different response criteria was poor. CONCLUSIONS: Most currently used response criteria do not predict clinical outcomes and have poor agreement. It is essential to establish a consensus on the definition of CRT response in order to standardize studies.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Port Cardiol. 2018 Dec;37(12):961-969.pt_PT
dc.identifier.doi10.1016/j.repc.2018.02.010pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3283
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectHSM CARpt_PT
dc.subjectCardiac Resynchronization Therapy/adverse effectspt_PT
dc.subjectCardiac Resynchronization Therapy/mortalitypt_PT
dc.subjectCardiac Resynchronization Therapy/statistics & numerical datapt_PT
dc.subjectEchocardiography/statistics & numerical datapt_PT
dc.subjectFollow-Up Studies
dc.subjectHeart Failure/mortality
dc.subjectHeart Failure/therapy
dc.subjectPredictive Value of Tests
dc.subjectProspective Studies
dc.subjectRisk Factors
dc.subjectStroke Volume/physiology
dc.subjectSurvival Analysis
dc.subjectTreatment Outcome
dc.titleImpact on Long-Term Cardiovascular Outcomes of Different Cardiac Resynchronization Therapy Response Criteriapt_PT
dc.title.alternativeImpacto dos Diferentes Critérios de Resposta à Terapia de Ressincronização nos Eventos Cardiovasculares a Longo Prazopt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage969pt_PT
oaire.citation.issue12pt_PT
oaire.citation.startPage961pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologiapt_PT
oaire.citation.volume37pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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