Abstract 11338: The WISE Score: A New Index for Predicting Outcome after Cardiac Resynchronization Therapy Using Simple Clinical Data
Background: Response to cardiac resynchronization therapy (CRT) is variable and factors associated with response complex. The aim of this study was to test the hypothesis that a new scoring system using simple clinical, ECG, and routine echocardiographic data may predict outcome after CRT.
Methods: We prospectively studied 209 consecutive CRT patients; NYHA class III/IV, QRS width ≥ 120ms, and ejection fraction ≤ 35%. Quantitative echocardiography was performed before CRT. Outcome events were pre-specified as death, transplant or left ventricular assist device. Risk factors were determined using a Cox regression model using these 4 simple clinical ECG and echo variables: disease etiology, QRS width, end-systolic dimension (indexed for body surface area) and pulsed Doppler interventricular mechanical delay (IVMD). Optimal cut-off values in continuous variables were decided by ROC curve analysis. A prognostic score was created by assigning 1 point for each: QRS Width (≤140ms), IVMD (<40 ms), Systolic dimension index (≥30mm/m2) and ischemic Etiology [acronym=WISE Score]. We calculated crude event rate per 100 patient-years for each prognostic score. Kaplan-Meier analysis was used with log-rank tested for significance.
Results: Over 4 years there were 59 events: 44 deaths, 9 transplants, and 6 left ventricular assist devices. The crude event rate per 100 patient-years after CRT were significantly related to the WISE prognistic score.
Conclusions: The WISE CRT score uses simple clinical, EGC and routine echo factors to predict response to CRT. The WISE score was significantly associated with long term outcome after CRT, and has potential for clinical applications.
- © 2011 by American Heart Association, Inc.