<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec id="j_jou.2022.0027_s_001">
<h3>Aim</h3>
<p>Response to cardiac resynchronization therapy varies significantly among patients, with one third of them failing to demonstrate left ventricular reverse remodeling after cardiac resynchronization therapy. Left atrial size and function is increasingly recognized as a marker of disease severity in the heart failure population. The aim of this study was to evaluate whether echocardiographic left atrial indices predict left ventricular reverse remodeling after cardiac resynchronization therapy.</p>
</sec>
<sec id="j_jou.2022.0027_s_002">
<h3>Materials and methods</h3>
<p>Ninety-nine cardiac resynchronization therapy candidates were prospectively included in the study and underwent echocardiography before and 3-months after cardiac resynchronization therapy implantation. Cardiac resynchronization therapy response was defined as a 15% relative reduction in left ventricular end-systolic volume. Indexed left atrial volume, left atrial reservoir strain, left ventricular end-diastolic volume, and left ventricular ejection fraction along with other known predictors of cardiac resynchronization therapy response (gender, etiology of heart failure, presence of typical left bundle branch block pattern, QRS duration >150 ms) were included in a multivariate logistic regression model to identify predictors for cardiac resynchronization therapy response.</p>
</sec>
<sec id="j_jou.2022.0027_s_003">
<h3>Results</h3>
<p>Cardiac resynchronization therapy response occurred in <italic>n</italic> = 63 (64%) patients. The presence of a typical left bundle branch block (OR 4.2, 95 CI: 1.4–12.1, <italic>p</italic> = 0.009), QRS duration >150 ms (OR 4.2, 95 CI: 1.4–11.0, <italic>p</italic> = 0.029), and left atrial volume index (OR: 0.6, 95 CI: 0.4–0.9, <italic>p</italic> = 0.012) remained the only significant predictors for cardiac resynchronization therapy response after three months. None of the baseline left ventricular parameters showed an independent predictive value.</p>
</sec>
<sec id="j_jou.2022.0027_s_004">
<h3>Conclusion</h3>
<p>Left atrial size at baseline is an independent predictor and is inversely proportional to left ventricular volumetric reverse remodeling in cardiac resynchronization therapy candidates.</p>
</sec>
</abstract>

Aim
Response to cardiac resynchronization therapy varies significantly among patients, with one third of them failing to demonstrate left ventricular reverse remodeling after cardiac resynchronization therapy. Left atrial size and function is increasingly recognized as a marker of disease severity in the heart failure population. The aim of this study was to evaluate whether echocardiographic left atrial indices predict left ventricular reverse remodeling after cardiac resynchronization therapy.


Materials and methods
Ninety-nine cardiac resynchronization therapy candidates were prospectively included in the study and underwent echocardiography before and 3-months after cardiac resynchronization therapy implantation. Cardiac resynchronization therapy response was defined as a 15% relative reduction in left ventricular end-systolic volume. Indexed left atrial volume, left atrial reservoir strain, left ventricular end-diastolic volume, and left ventricular ejection fraction along with other known predictors of cardiac resynchronization therapy response (gender, etiology of heart failure, presence of typical left bundle branch block pattern, QRS duration >150 ms) were included in a multivariate logistic regression model to identify predictors for cardiac resynchronization therapy response.


Results
Cardiac resynchronization therapy response occurred in n = 63 (64%) patients. The presence of a typical left bundle branch block (OR 4.2, 95 CI: 1.4–12.1, p = 0.009), QRS duration >150 ms (OR 4.2, 95 CI: 1.4–11.0, p = 0.029), and left atrial volume index (OR: 0.6, 95 CI: 0.4–0.9, p = 0.012) remained the only significant predictors for cardiac resynchronization therapy response after three months. None of the baseline left ventricular parameters showed an independent predictive value.


Conclusion
Left atrial size at baseline is an independent predictor and is inversely proportional to left ventricular volumetric reverse remodeling in cardiac resynchronization therapy candidates.

Predictive value of left atrial remodeling for response to cardiac resynchronization therapy

sjoerd.bouwmeester@catharinaziekenhuis.nl

Journal of Ultrasonography

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Aim
Response to cardiac resynchronization therapy varies significantly among patients, with one third of them failing to demonstrate left ventricular reverse...

Predictive value of left atrial remodeling for response to cardiac resynchronization therapy

Article Category: research-paper

Published Online: Sep 01, 2022

Page range: e168 - e173

Received: Mar 10, 2022

Accepted: Jun 07, 2022

DOI: https://doi.org/10.15557/jou.2022.0027

Keywords
heart failure, cardiac resynchronization therapy, left atrial remodeling, left atrial strain, left ventricular reverse remodeling

© 2022 Sjoerd Bouwmeester et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Predictive value of left atrial remodeling for response to cardiac resynchronization therapy

Article Category: research-paper

Published Online: Sep 01, 2022

Page range: e168 - e173

Received: Mar 10, 2022

Accepted: Jun 07, 2022

DOI: https://doi.org/10.15557/jou.2022.0027

Keywordsheart failure, cardiac resynchronization therapy, left atrial remodeling, left atrial strain, left ventricular reverse remodeling

© 2022 Sjoerd Bouwmeester et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Keywords
heart failure, cardiac resynchronization therapy, left atrial remodeling, left atrial strain, left ventricular reverse remodeling