Title: Predictors of super-responders to cardiac resynchronization therapy for congestive heart failure in bangladeshi population

Biography:

Abstract

Cardiac Resynchronization Therapy (CRT) is the established management for HF patients with LV systolic dysfunction and signs of electrical dyssynchrony. Some patients after CRT implantation become ‘super-responders’. Our proposed definition of super-responders is patients with an increase LVEF of ≥15% and an improvement of (NYHA) functional class (at least 1 class). The aim of our study was to identify predictors of being a super-responder to CRT in our population.

Thirty five consecutive patients underwent CRT for a period of one year were studied prospectively. Before and 3months after implantation clinical, electrocardiographic and echocardiographic evaluations were performed. At the 3 months follow-up, patients were classified as ‘super-responders’.

Of the 35patients, there were17.1%super-responders. At baseline, there were some significant differences between super-responders and the other patients that they had significantly smaller LV end-diastolic diameter (65.4±6.4vs.73.4±9.3mm,P=0.001), smaller degree of MR(mean 1.9±0.9vs.2.6+0.8,P=<0.001), smaller left atrium (42.8±4.6vs.50.0±6.5 mm, P < 0.001), a shorter duration of HF symptoms (months; 15.1±17.8vs.33.9±35.7,P=0.01) and they all had non-ischemic cardiomyopathy. After 3 months, we observed a significant improvement of NYHA functional class, LVEF, LV diameters, MR grade in both groups. Regarding the magnitude of response LV diameters, LVEF showed a significantly greater improvement in super-responders. In the multivariate logistic regression analysis, MR grade, LVEDD and the duration of symptoms for <12 months were independent predictors of super-response to CRT.