Abstract 9521: Ventricular Dyssynchrony at Baseline Predicts Transplant-Free Long-Term Survival in Patients Treated by Cardiac Resynchronization Therapy
Aims: To analyze whether left ventricular dyssynchrony (LVD) at baseline is predictive for long-term outcome in heart failure (CHF) patients with left ventricular (LV) dysfunction and conduction disturbances treated with cardiac resynchronization therapy (CRT).
Methods: In 504 consecutive individuals with CHF scheduled for implantation of a CRT device, LVD was assessed by tissue Doppler imaging (TDI), defined as an electromechanical delay (EMD) difference of ≥40 ms in 2 opposed left ventricular wall regions (septal vs. lateral, anterior vs. inferior). All-cause mortality, heart transplantation, or assist device implantation was defined as combined primary end point. Secondary end points were measures of reverse LV remodeling and of symptomatic improvement.
Results: Mean follow-up was 68±36 months. LVD at baseline was present in 308 patients (61%). Of these, 24% reached the combined primary endpoint in contrast to 58% of patients without LVD (p<0.001). Furthermore, patients with LVD showed pronounced improvement of all secondary end point parameters. An independent association was found between outcome, LVD (β-coefficient in the final model 0.4, p<0.001), and gender (β-coefficient in the final model 0.2, p=0.002).
Conclusions: LVD at baseline as assessed by TDI is associated with more pronounced reverse LV remodeling and seems to be a predictor for transplant-free long-term survival in CRT recipients.
- © 2012 by American Heart Association, Inc.