title: Identification and characterization of super-responders after cardiac resynchronization therapy.
abstract: Cardiac resynchronization therapy (CRT) has been shown to induce a spectacular effect on left ventricular (LV) function in certain patients. Our aim was to analyze and characterize the super-responders (SRs) to CRT using echocardiography in 186 patients with a conventional indication according to the European Society Cardiology guidelines. The investigation took place before and 6 months after implantation. CRT-SRs were defined by an improvement of the New York Heart Association functional class and LV ejection fraction to > or = 50% in absolute values associated with a relative LV end-systolic volume reduction of > or = 15%. Of the 186 patients, 18 (9.7%) were identified as CRT-SRs and had a significantly lower prevalence of ischemic etiology (11%), lower LV dimensions, lower left atrial volume, and greater global longitudinal strain at baseline. Receiver operating characteristics curves identified global longitudinal strain as the strongest parameter for predicting CRT-SRs, with a cutoff value of -12% (area under the curve 0.87, sensitivity 71%, and specificity 85%, p <0.01). In conclusion, in the present retrospective study, only a left atrial volume <55 ml and global longitudinal strain < or = -12% were independent predictors of CRT-SRs.
authors.affiliation: CHU de Bordeaux, Bordeaux, France. patricia.reant@chu-bordeaux.fr
authors.forename: Patricia
authors.initials: P
authors.lastname: Reant
authors.forename: Amira
authors.initials: A
authors.lastname: Zaroui
authors.forename: Erwan
authors.initials: E
authors.lastname: Donal
authors.forename: Aude
authors.initials: A
authors.lastname: Mignot
authors.forename: Pierre
authors.initials: P
authors.lastname: Bordachar
authors.forename: Antoine
authors.initials: A
authors.lastname: Deplagne
authors.forename: Aude
authors.initials: A
authors.lastname: Solnon
authors.forename: Philippe
authors.initials: P
authors.lastname: Ritter
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Daubert
authors.forename: Jacques
authors.initials: J
authors.lastname: Clementy
authors.forename: Christophe
authors.initials: C
authors.lastname: Leclercq
authors.forename: Raymond
authors.initials: R
authors.lastname: Roudaut
authors.forename: Gilbert
authors.initials: G
authors.lastname: Habib
authors.forename: Stephane
authors.initials: S
authors.lastname: Lafitte
mesh_terms: D000368:Aged; D002306:Cardiac Volume; D017147:Defibrillators, Implantable; D015150:Echocardiography, Doppler; D004554:Electric Countershock; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D016896:Treatment Outcome; D016276:Ventricular Function / Q000502:physiology